Barotrauma is an injury that occurs due to sudden changes in air pressure. This condition is often experienced by a diver or a person who regularly travels by airplane.
Barotrauma generally occurs in the ear. This condition is characterized by a feeling of tightness in the ears due to differences in air pressure inside and outside the ear. Barotrauma can occur not only in the ear, but also in the lungs and digestive tract.
Causes of Barotrauma
Barotrauma is caused by differences in air pressure inside and outside the ear. Barotrauma often occurs when planes take off and land. In this condition, the air pressure in the aircraft cabin changes rapidly. If the ear does not adapt quickly to balance the air pressure in the ear, then barotrauma occurs.
Barotrauma can also occur when diving (scuba diving). The deeper a person dives, the higher the pressure. If you're not good at balancing the pressure in your ear and you're still forced to dive, this pressure can rupture the eardrum.
In addition to flight and diving activities, barotrauma can also occur due to the influence of the following conditions:
- Suffered an ear injury from the explosion
- Undergoing hyperbaric oxygen therapy
- Take a hike to the top of the mountain
- Drive a vehicle on hills or mountains
- Ride or get off the elevator from or to a higher floor
The pressure in the ear will adjust to the pressure in the outside world through a channel connected to the nose (Eustachian tube). When Eustachian tube congestion, for example when you have a cold or have otitis media, the risk of barotrauma increases. Barotrauma is also more at risk for someone who has a family who has had barotrauma.
In addition to attacking the ears, barotrauma can also attack the lungs and digestive tract. Pulmonary barotrauma can occur while diving or when a person is on an airplane.
Symptoms of Barotrauma
The initial symptoms of barotrauma are mild and can be treated simply by swallowing or chewing. Early symptoms of barotrauma are:
- A feeling of fullness and discomfort in one or both ears.
- Ear pain.
- Decreased hearing.
- Dizzy.
If left unchecked and pressure changes continue, more serious barotrauma symptoms can appear. The symptoms in question are:
- Severe pain in the ear.
- Ears ringing.
- Vertigo.
- Throw up.
- Bleeding or discharge from the ear.
- Hearing loss.
In contrast to barotrauma to the ear, barotrauma to the lungs is characterized by several symptoms, such as hoarseness, chest pain, and shortness of breath. Meanwhile, the symptoms of barotrauma that occur in the digestive tract include abdominal pain and cramps, and flatulence.
When to go to the doctor
If you experience serious symptoms of ear barotrauma, consult a doctor immediately. Treatment needs to be done immediately to prevent further damage to your hearing.
Immediately contact medical assistance or visit the nearest hospital, if symptoms of barotrauma appear after diving. Moreover, the symptoms are getting worse or symptoms arise, such as:
- Coughing up blood
- Hard to breathe
- Loss of balance
- Paralysis of the arms or legs
- Decreased consciousness
If the above symptoms appear, it is advisable to visit a hospital that has hyperbaric oxygen therapy facilities because you may have decompression sickness.
If you have a cold, have an ear infection, or your allergies are relapsing, and are planning to travel by plane in the near future, it's best to talk to your doctor first. Likewise if you plan to do diving activities.
For pilots or crew members, it is necessary to meet a doctor for a medical check-up once a year. Even pilots who are over 40 years old are required to undergo a health check every six months. The inspection aims to prevent flight-related diseases, such as barotrauma, and maintain passenger safety.
Likewise with professional divers. They are required to undergo a medical check-up at least once a year, in addition to a health check that is carried out before diving.
Diagnosis of Barotrauma
Ear barotrauma can be felt by sufferers themselves when diving or traveling by airplane. If the symptoms do not improve for several days, then a doctor's examination is necessary.
The doctor will ask about the symptoms that appear and the patient's medical history. The doctor will also examine the patient's ear using an instrument called an otoscope to see conditions inside the ear canal.
If necessary, the doctor will perform a follow-up examination to confirm the diagnosis and the consequences. The types of follow-up examinations carried out are:
- Hearing test, to check hearing function and detect damage to the ear.
- X-rays, to detect accumulations of fluid or air in parts of the body, such as the sinuses or abdominal cavity.
- CT scan or MRI, to check the condition of organs suspected of experiencing barotrauma, such as the lungs or digestive tract.
Barotrauma Treatment
Most barotrauma can heal on its own without special treatment from a doctor. To relieve ear pain or discomfort during flight, you can take the following simple steps:
- Eating candy or chewing gum.
- If you don't have candy, try yawning or swallowing.
- If that doesn't work, pinch your nose, inhale through your mouth, and try to keep exhaling through your nose slowly.
Ear barotrauma that occurs when diving can also be treated with special techniques. Make sure you have received training and certificates before diving.
Drugs
If the simple steps above are not effective and the symptoms do not go away, then medical treatment needs to be done. One of them is with medicine. Some types of drugs that doctors can give, among others:
- Decongestants
- Antihistamines
- Pain reliever
Operation
Surgery may be performed in severe barotrauma. This procedure is done by implanting a special instrument such as a tube in the eardrum. This cylindrical tube serves to circulate air into the inner ear so that the pressure inside the ear equals the pressure in the outside world.
Another surgical method that can be performed by an ENT doctor is to make a small incision in the eardrum (myringotomy).
Management of barotrauma in infants and children
If you are taking your baby on a flight and your baby is showing symptoms of barotrauma, try feeding or drinking to relieve the symptoms. Pacifiers can also be used to treat pain and anxiety.
If symptoms do not improve, the doctor will prescribe ear drops to help relieve pain in the child's ear.
Barotrauma Complications
Barotrauma, especially the ear, is usually transient and rarely causes complications. However, complications can still occur, especially in severe barotrauma. Complications that can arise include:
- Ear infection
- ruptured eardrum
- Hearing loss to permanent hearing loss
- Vertigo
- Bleeding from ears and nose
Pulmonary barotrauma can also cause dangerous complications, especially in patients who have previously suffered from impaired lung function. Some of the complications that can arise are:
- Cardiac tamponade.
- Pulmonary embolism.
- Pneumothorax and subcutaneous emphysema.
- Pneumomediastinum, which is a buildup of air in the center of the chest, causing chest pain, difficulty swallowing, and voice changes.
Barotrauma Prevention
The main step to prevent ear barotrauma is to keep Eustachian tube stay open. This step can be done by:
- Take medicineIf you have a cold, take a decongestant about an hour before your flight. In addition, antihistamines can also be used. Consult this first with your doctor.
- Use earplugs (earplugs)Special earplugs for air travel can be used to slow pressure changes and give the ear time to adjust.
Prevention of in-flight barotrauma
If your ears hurt during flight, try these ways to relieve pain and prevent barotrauma:
- Don't sleep when the plane is about to land. Try yawning or swallowing to relieve stuffy ears.
- Consume candy or chew gum. Chewing and swallowing movements can help control air pressure in the ear.
- Drink during the flight. This action can keep Eustachian tube remains open and helps thin mucus in the respiratory tract.
- Inhale, then pinch your nose with your fingers and cover your mouth, then exhale slowly through the closed nose.
If you bring your baby on a flight, make sure your baby doesn't fall asleep when the plane is about to land. You can use a pacifier to help your baby stay awake.
The best prevention of barotrauma while diving is to apply good diving technique. You can learn the correct diving technique through certified training.
