What Is Ear Barotrauma?

Ear pressure injury, also known as barotraumatic otitis media, is caused by the difference in pressure between the inside and outside of the tympanum when the air pressure inside the drum cannot be changed with the drastic changes in outside atmospheric pressure. Otitis media in aviation; cause of diving caissons, etc., are called diver's otitis.

Ear barotrauma

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Ear pressure injury, also known as barotraumatic otitis media, is caused by the difference in pressure between the inside and outside of the tympanum when the air pressure inside the drum cannot be changed with the drastic changes in outside atmospheric pressure. Otitis media in aviation; cause of diving caissons, etc., are called diver's otitis.

Western Medicine Name

Ear barotrauma

Other name

Barotraumatic otitis media

Multiple groups

Pilot, diver

Contagious

Non-contagious

Precaution

Strict selection of personnel and regular medical examinations

The Eustachian tube is the channel that connects the tympanic cavity to the nasopharynx. Under normal circumstances, the Eustachian tube is closed. It opens momentarily when opening, swallowing, yawning, singing, and blowing your nose hard to adjust the air pressure in the tympanic cavity. When suffering from non-pathological factors such as rhinitis, pharyngitis, sinusitis, nasal and nasopharyngeal tumors, poor tooth occlusion, cleft palate or swelling of the eustachian tube mucosa, scarring, and lack of health prevention knowledge, falling asleep when the plane descends, etc. Both can affect the ventilation function of the eustachian tube and are susceptible to this disease. When the outside air pressure drops rapidly, such as when the airplane rises, the tympanum is in a relatively high pressure state. The positive pressure in the tympanum makes the tympanum convex. When the pressure difference between the inside and outside of the tympanum reaches 2. In OkPa, the air pressure in the tympanic chamber exceeds the pressure of the tissue surrounding the cartilage of the Eustachian tube. The air in the tympanum can burst out of the Eustachian tube to make the air pressure inside and outside the tympanic tube basically maintain a balance. Less prone to middle ear barotrauma. When the external air pressure increases sharply, such as a sudden drop in the aircraft, the tympanic chamber will form a negative pressure state and the tympanic membrane will be invaded; the eustachian tube cartilage will act as a one-way valve, and the pharyngeal opening will not be easily affected by the surrounding high air pressure. As a result, it is difficult for outside air to enter the tympanum, resulting in an increase in negative pressure in the middle ear. Negative ear pressure can make the blood vessels in the mucosa dilate and leak or bleed, and edema of the mucosa. Fluid in the tympanic cavity. Submucous hemorrhage or hemorrhage in the tympanic cavity can occur in severe cases (Figure 1); the tympanic membrane is congested, invaded, or even ruptured. Similarly, every time a diver dives a depth of 10 meters, an atmospheric pressure is added, such as not inhaling compressed air. Can also cause middle ear pressure injury.

When the airplane gradually rises, or the diver gradually rises to the surface, the pressure in the drum chamber is higher than the outside air pressure, and the eustachian tube has an automatic adjustment effect, so fewer symptoms occur, and occasionally ear discomfort, ear tightness, tinnitus, or hearing loss . on the contrary. When the plane suddenly dives down or the submerged box sinks rapidly, the eustachian tube loses its regulating effect. Especially under pathological conditions, ear pressure injury is more likely to occur. In mild cases, symptoms are not obvious, in severe cases, sudden ear tingling, ear tingling, tinnitus, and deafness; if the tympanic negative pressure continues to increase, the above symptoms gradually increase, and ear pain can radiate to the temporal and cheeks; sometimes negative pressure passes through the tympanic cavity. Two windows on the inner wall stimulate the labyrinth and cause dizziness, nausea, and vomiting. A few can cause sensorineural hearing loss; if the tympanic membrane is ruptured, the tympanic negative pressure disappears, and ear pain can be relieved. Examination showed congestion of the tympanic membrane, especially in the slack and malleolus. The tympanic membrane sometimes had blood bubbles, stains, or fissure-like perforations of the tympanic membrane. If the tympanic fluid is accumulated, the liquid level or air bubbles can be seen through the tympanic membrane. If the tympanic fluid is accumulated, the tympanic membrane can be blue. Hearing tests are often conducted for deafness.

First of all, measures should be taken to restore the air pressure balance inside and outside the drum, such as swallowing, chewing, yawning, etc., and performing eustachian tube bloating. Decongestants are used in the nose or nasopharynx, and ears can be treated with physical therapy such as infrared or ultrashort wave. Apply antibiotics systemically to prevent secondary infections. If there is tympanic fluid or hemorrhage, tympanocentesis or tympanostomy can be performed under aseptic operation. Those with ruptured eardrum should keep the external auditory canal clean and dry, and wait for them to heal themselves. Those with rupture of the window film should perform tympanic exploration and window film repair.

Strict selection of pilots and divers, regular physical examination, those with nasal cavity, nasopharyngeal disease, or middle ear infections should suspend flight or dive, and actively treat, strengthen related health education and work, and usually conduct open eustachian tube training exercises, such as swallowing , Laryngeal movement, soft palate movement and mandibular movement. Passengers are not allowed to fall asleep while the plane is descending, and are constantly swallowing, such as chewing gum, yawning, drinking beverages, or pinching their noses to keep their breath open, to keep the eustachian tube open.