BAROTITIS MEDIA (Barotrauma) |
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General Information
DEFINITION--Damage to the middle ear caused by pressure changes. This is very common in scuba divers.
SIGNS AND SYMPTOMS
Hearing loss (to varying degrees).
A plugged feeling in the ear.
Severe pain.
Dizziness.
Ringing noise in the ear.
CAUSES & RISK FACTORSDamage caused by sudden, increased pressure in the surrounding air, such as occurs in the rapid descent of an airplane or while scuba diving. In these activities, air moves from passages in the nose into the middle ear to maintain equal pressure on both sides of the eardrum. If the tube leading from the nose to the ear (eustachian tube) doesn't function properly, pressure in the middle ear is less than outside pressure. The negative pressure in the middle ear sucks the eardrum inward. Blood and mucus may later appear in the middle ear. This damage is more likely if you have a nose or throat infection when scuba diving or traveling by air.
HOW TO PREVENT
Don't scuba-dive when you have an upper-respiratory infection.
On feeling ear pain while scuba diving, stop the descent, ascend a few feet and try to equalize pressure. If you cannot equalize the pressure, terminate the dive.
If flying, take a moderate-size breath, hold the nose and try to force air into the eustachian tube by gently puffing out the cheeks with the mouth closed.
WHAT TO EXPECT
DIAGNOSTIC MEASURES
Your own observation of symptoms.
Medical history and exam by a doctor.
SURGERYSometimes necessary to open the eardrum and release fluid trapped in the middle ear. A plastic tube may be inserted through the surgically perforated eardrum to keep it open and equalize pressure. The tube falls out spontaneously in 9 to 12 months.
NORMAL COURSE OF ILLNESSWith treatment, most cases of barotitis media are reversible without permanent damage or hearing loss.
POSSIBLE COMPLICATIONSWithout treatment, fluid may accumulate, become infected and rupture the eardrum. The rupture may affect nerve endings, causing permanent hearing loss.
HOW TO TREAT
NOTE -- Follow your doctor's instructions. These instructions are supplemental.
MEDICAL TREATMENTSee your doctor for prescription of medications and surgery (sometimes).
HOME TREATMENTIf fluid drains from the ear, place a small piece of cotton in the outer-ear canal to absorb it.
MEDICATION
For minor discomfort, you may use non-prescription decongestants and pain relievers such as acetaminophen.
Your doctor may prescribe:
Stronger prescription decongestant nasal sprays or tablets. Use for at least 2 weeks after damage.
Corticosteroid nasal spray.
Antibiotics if infection is present.
ACTIVITYResume normal activities as soon as symptoms improve. If surgery is necessary to insert tubes in the ears, keep water out of the ears. Consult your doctor about special ear plugs for use during swimming, bathing and shampooing.
DIETNo special diet.
CALL YOUR DOCTOR IF
You have symptoms of barotitis media.
Severe ear pain, severe headache, fever or dizziness occur during treatment.
New, unexplained symptoms develop. Drugs used in treatment may produce side effects.
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