Barotrauma is A Condition Due to Changes in Altitude

When the pressure rises…

Barotrauma is a condition that affects your ears due to changes in altitude. If you’re planning to go scuba diving or get on a plane this holiday season, here’s how you can avoid unwanted discomfort and pain.

The holidays are here and everyone’s in a great mood. You get to take a well-deserved break after a long year of hard work, the kids are on their school break and it’s finally time to pack your bags and head for that gorgeous island for a scuba diving vacation or maybe to the mountains for a spot of skiing.

However for some, heading to places with higher or lower altitudes can turn out to be a dreadful experience. Due to the changes in atmospheric pressure, you may feel sudden pain, pressure or ringing in the ear — symptoms that point to a condition called barotrauma.

We speak to Consultant ENT Head & Neck Surgeon from Sunway Medical Center, Dr. Lee Leong Meng on what barotrauma is all about.

How does it happen?

Firstly, Dr. Lee explains that, “Barotrauma is an injury that occurs in the middle ear due to changes in atmospheric pressure. Sometimes, this can happen to the sinuses (spaces around the nasal cavity) as well but it is less common compared to the middle ear.”

Dr. Lee says that the pressure in our middle ear should be the same as the natural atmospheric pressure in the environment.  Hence, as the pressure of your surroundings change, the pressure in your middle ear is supposed to adjust accordingly. The Eustachian tube, which is a spherical canal that runs from your nose to your middle ear, helps maintain equal pressure and when it gets blocked, barotrauma can occur. You may be wondering, “How do I know if my Eustachian tube is blocked?” Dr. Lee explains that, “Sometimes it can get blocked due to the common cold, mucous or congestion due to environmental factors such as cold air and haze.”

However, barotrauma does not occur the minute you feel pain or pressure in your ears due to the change in altitude. “Before barotrauma occurs, there must be a significant and persistent amount of pressure that occurs,” clarifies Dr. Lee. It is normal to feel a certain amount of pressure when there is a change in altitude and your ears are unable to adjust to the pressure immediately. However, the discomfort usually goes away in a short period of time.

What to look out for…

Dr. Lee says there are two common situations when a person can experience barotrauma — on a plane that is descending or during a scuba diving expedition. Here are Dr. Lee’s tips to equalise the pressure in your ears and avoid barotrauma:

When on a plane…

  • Yawn
  • Drink or eat
  • Chew gum
  • Stay awake while the plane is descending and attempt to equalise the pressure in your ears by using the methods listed above
  • Give kids juice or something to eat, to avoid discomfort

When scuba diving…

  • Constantly equalise ear pressure based on the techniques your dive instructor taught you
  • Do not descend deeper into the ocean if you are unable to equalise ear pressure in shallow waters

By practicing the steps above, Dr. Lee assures that you should be able to equalise the pressure in your ears fairly easily. However, if this does not happen, you may start to feel further discomfort which includes pain and this can eventually lead to barotrauma.

Some of the signs and symptoms of barotrauma include:

  • Pain in the ears
  • Persistent blocked ears
  • Tinnitus (abnormal sound in the ears)
  • Bleeding in the ear drum
  • Facial pain and headaches

If the above signs and symptoms persist, consult an ENT expert for a diagnosis. “In some cases, you may be permanently affected by barotrauma. However, generally, with the right treatment, it is curable,” assures Dr. Lee. However he adds that in some severe cases, the injury may not only be permanent, it can also affect your cochlear. Hence, it is important that this condition be detected and treated early.

Can it be prevented?

The good news is, yes barotrauma can be prevented. All you’ll need to do is to be aware of the symptoms and take steps to prevent them. “For instance, if you have a flu, you should treat it before you get on a plane,” explains Dr. Lee. He also advises parents, to ensure that their children are healthy and not having the flu when they need to fly.

Also, if you have medical conditions such as sinusitis and so on, be sure to consult your doctor before travelling. Dr. Lee shares that this condition is relatively common among Malaysians and his message to all travelers on how to avoid barotrauma is this: prevent and equalise pressure in your ears as soon as you need to.


Barotrauma in Sinuses

Although, barotrauma that occurs in the sinuses is less common, you should also be aware of the signs and symptoms:

  • Facial pain
  • Blood in the secretion from the nose

Ways to prevent barotrauma in the sinuses are the same as barotrauma in the middle ear. The most important thing you should take note of is to be aware of the symptoms and seek treatment if the discomfort around your sinuses persists.

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Is it Safe to ‘Pop’ the Bubble in your Ears?

When your ear is blocked, popping the bubble in your ears (by closing your nose and blowing through your mouth) may seem like the best way to regain your hearing. However, is this safe? According to Dr. Lee, doing so is generally safe and in fact, it may help to equalise pressure and avoid barotrauma. “It is uncommon to pop your ears so hard that it can cause an injury in your ear drums,” he says.

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