Barotitis media is an inflammation of the ear caused by changes in atmospheric pressure. It is also called aerotitis.
This is a problem of inflammation or bleeding in the middle ear caused by a difference between the air pressure in the middle ear and that of the atmosphere - as occurs in sudden changes of altitude, in diving, and in hyperbaric chambers.
During a sudden increase in ambient pressure, gas must move from the nasopharynx into the middle ear to maintain equal pressure on both sides of the tympanic membrane (ear drum). If the eustachian tube (connecting the middle ear to the back of the nose) is not functioning properly, as in upper respiratory tract infections or allergy, the pressure in the middle ear is lower than the ambient pressure. The relative negative pressure in the middle ear results in retraction of the tympanic membrane and a transudate of blood from the vessels in the lamina propria of the mucous membrane forms in the middle ear.
Very severe pressure differentials cause bleeding into the middle ear and rupture of the tympanic membrane. A perilymph fistula through the oval or round window may occur.
Upper respiratory inflammation or allergy may obstruct eustachian tubes or sinus ostia, resulting in barotitis media or a sinusitis.
A sensorineural hearing loss or vertigo during descent suggests the possibility of a perilymph fistula, while the same symptoms during ascent from an aquatic dive suggest bubble formation in the inner ear.
In most cases, no treatment is necessary and symptoms disappear in hours or days. If fluid drains from the ear, place a small piece of cotton in the outer-ear canal to absorb it. Rarely, surgery may be required 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.
For minor discomfort, you may use non-prescription decongestants and pain relievers, such as acetaminophen. You may be prescribed stronger prescription decongestant nasal sprays or tablets. Use for at least 2 weeks after damage. Antibiotics may be taken if infection is present.
To prevent it from happening, you may do frequent yawning or closed-nose swallowing during descent from a high altitude. Decongestant nasal sprays and antihistamines may also be taken before or during flight travels to avoid the condition.
Children are particularly susceptible to barotitis media and should be given oral fluids or feeding during descent to encourage swallowing (chewing gum or hard candy is even more effective than eating).
WHAT YOU SHOULD DO
Don't take any medicine without your doctor's approval. Do not put anything into your ears to clean or unplug them. Do not swim or dive until your doctor says it is okay. Avoid flying or scuba-diving when you have a head cold. If you must fly: Call your doctor for medicine to keep your ears unplugged. Chew gum or suck on candy when the airplane is taking off and landing. This will force you to swallow often and will equalize the air pressure in your middle and outer ears. Take a breath, hold your nose, close your mouth. This will force air into the eustachian tube. To prevent the problem in an infant, breastfeed or give the baby a bottle of water or juice on takeoff and landing.
See your E.N.T. Doctor If...
You get a painful headache or a really bad earache, you feel dizzy, or you have blood or pus-like drainage from the ear. You develop a high temperature. Your symptoms do not get better or they become worse.
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