Barotrauma

Barotrauma is physical damage to body tissues caused by unequal pressure between an air-filled space inside the body and the surrounding environment. It occurs when barometric or water pressure changes rapidly, preventing pressure equalization.

The most common form is ear barotrauma, affecting the middle ear during airplane takeoff/landing or scuba diving. Pressure differences stretch or rupture the eardrum, causing pain, fullness, muffled hearing, tinnitus, dizziness, and sometimes fluid or blood leakage. Sinus barotrauma produces facial pain and headaches, while pulmonary barotrauma—rare but serious—can cause lung overexpansion, pneumothorax, or arterial gas embolism in divers.

Risk factors include nasal congestion, colds, allergies, and Eustachian tube dysfunction, which block pressure equalization. Prevention involves yawning, chewing gum, swallowing, or performing the Valsalva maneuver (gently blowing while pinching the nose) during pressure changes.

Most mild cases resolve spontaneously with self-care. Treatment includes decongestants, nasal steroids, pain relievers, and keeping the ear dry. Severe cases may require antibiotics for infection, myringotomy (surgical eardrum incision) for fluid drainage, or ventilation tube placement for recurrent barotrauma.

Understanding pressure dynamics and avoiding altitude changes during illness significantly reduces barotrauma risk for travelers and divers alike.