( Ear Barotrauma, Barotitis Media, Ear Popping, Ear Pressure, Airplane Ear; Sinus Barotrauma, Aerosinusitis, Barosinusitis; Pulmonary Barotrauma, Pulmonary Overpressurization Syndrome)
- Ear (most common)—affecting structures in the middle ear
- Sinus—air-filled facial sinuses surround the bones in the skull
- Pulmonary (most critical)—lungs
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- Sudden or severe changes in surrounding pressure
- Blockages in the body's air cavities
- Airplane travel
- Ascending (going up to the surface) without exhaling freely
- Swimming quickly to the surface when diving
- Holding your breath when ascending
- Underwater diving for an increased period of time
- Repeated dives within 24 hours
- Flying in an airplane after diving
- Having air pockets in equipment (such as masks and dry suits)
- Mechanical ventilation—use of a machine to move air into and out of the lungs (associated with pulmonary trauma)
- Exposure to shock waves from an explosion
- Congestion from allergies or colds
- Middle ear infections—more common in younger children
- Defects of eustachian tube (small tube that runs from the middle ear to the back of the nose and upper throat and helps stabilize internal and external pressures)
- Damaged or blockage of eustachian tube—resulting from scarring or a tumor
- Cleft palate or lip
- Nasal congestion from a sinus infection, cold, or allergies
- Structural defects of the sinuses or their drainage system
- Discomfort or pain in one or both ears
- Feeling as though your ears are clogged
- Feeling of pressure in your ears
- Ringing in the ear—tinnitus
- Temporary hearing loss
- Rarely, bleeding from the ear
- Sinus pressure and/or pain
- Feeling of fullness in the head
- Nasal bleeding
- Tooth pain
- Shortness of breath
- Chest pain
- Feeling of fullness in the chest
- Pain that radiates to the neck and/or shoulders
- Degrees of consciousness
Measures to Relieve Pressure
- Suck candy
- Chew gum
- Inhale and gently exhale through your nose while pinching your nostrils shut. This forces air through the blocked eustachian tube and possibly opens it.
- Decongestant nasal sprays
- Oral decongestants
- Oral antihistamines
- If you can, postpone your flight if you have a cold or are congested. Use a decongestant if travel can not be delayed.
- To relieve the pressure during take-off and landing, try:
- Sucking candy
- Chewing gum
- Breathing with your mouth open
- Use filtered earplugs to slowly equalize the air pressure against your eardrum.
- Avoid sleeping during descent because you may not be swallowing enough.
- Get proper training and certification.
- Make sure all your equipment is working and vented properly.
- Keep diving depth to level of experience.
- Follow all breathing guidelines, especially when coming up from a dive.
- Don’t stay under the water at greater depths long periods of time.
- Avoid flying or going to a higher altitude for the next 24 hours after diving.
- Take a decongestant pill or nasal spray a little before diving.
American Academy of Otolaryngology—Head and Neck Surgery http://www.entnet.org
Divers Alert Network http://www.diversalertnetwork.org
Canadian Society of Otolaryngology—Head and Neck Surgery http://www.entcanada.org
Health Canada http://www.hc-sc.gc.ca
Barotrauma. American Hearing Research Foundation website. Available at: http://american-hearing.org/disorders/barotrauma. Updated October 2012. Accessed November 4, 2014.
Barotrauma. The Merck Manual Professional Edition website. Available at: http://www.merckmanuals.com/professional/injuries%5Fpoisoning/injury%5Fduring%5Fdiving%5For%5Fwork%5Fin%5Fcompressed%5Fair/barotrauma.html. Updated May 2013. Accessed November 3, 2014.
Brandt MT. Oral and maxillofacial aspects of diving medicine. Military Medicine. 2004;169:137-141.
Ears and altitude. American Academy of Otolaryngology—Head and Neck Surgery website. Available at: http://www.entnet.org/content/ears-and-altitudeearsAltitude.cfm. Updated February 2, 2012. Accessed November 4, 2014.
Newton HB. Neurologic complications of scuba diving. Am Fam Physician. 2001;63(11):2211-2218.
- Reviewer: Marcin Chwistek, MD
- Review Date: 11/2014 -
- Update Date: 01/15/2014 -