Barotrauma

What is barotrauma?

Barotrauma happens when sudden changes in barometric (air) or water pressure damage your body. Airplane ear (ear injury barotrauma) is a common example of barotrauma. Barotrauma can be a serious medical issue, particularly barotrauma that affects your lungs.

What are examples of barotrauma?

Examples of barotrauma include:

Ear barotrauma (airplane ear)

This type affects your middle ears. Ear injury barotrauma can happen during scuba diving or flying in an airplane. Ear barotrauma may make your ears feel full and you may have trouble hearing. Rarely, ear barotrauma causes a ruptured eardrum.

Sinus barotrauma (sinus squeeze or barosinusitis)

Sudden or extreme changes in air or water pressure may put pressure on your sinuses, making them hurt. Like pulmonary barotrauma, sinus barotrauma is associated with scuba diving.

What causes barotrauma?

Barotrauma represents a 17th century discovery about the nature of gas. Physicist Robert Boyle discovered the relationship between pressure placed on objects containing a gas like oxygen and how much space that gas takes up.

Under Boyle’s law, gases — such as air inside of your lungs, sinuses or ears — take up less space when outside pressure increases. When that outside pressure decreases, gases take up more space. Barotrauma happens when outside air or water pressure changes faster than your body can safely adapt.

Boyle’s law plays out when you’re flying in an airplane and your ears begin to feel as if they’re stuffed with cotton when the plane takes flight or starts to land.

That stuffed-up feeling happens because the rapid change in air pressure affects your eustachian tubes connecting your middle ear and the back of your nose. The tubes manage the amount of pressure on your eardrum, making sure there’s equal pressure on both sides of your eardrum. When air pressure changes quickly, it upsets the balance of pressure on your middle ear.

What are barotrauma symptoms?

Symptoms vary depending on how a sudden change in air or water pressure affects different parts of your body.

Ear barotrauma symptoms

• Severe ear pain.
• Dizziness.
• Nausea and vomiting.
• Feeling disoriented.

Pulmonary (lung) barotrauma symptoms

Symptoms vary depending on the underlying cause. For example, people who scuba dive may develop pulmonary barotrauma if they hold their breath when they swim up to the water’s surface. In that situation, symptoms include:

• Chest pain.
• Shortness of breath (dyspnea).
• Bloody nose.
• Bloody froth at your mouth.

Sinus barotrauma symptoms

• Facial pain.
• Headaches.
• Bloody nose
• Congestion.

How is barotrauma diagnosed?

Diagnosis depends on the type of barotrauma. For example, a healthcare provider will use different tests to diagnose ear barotrauma and pulmonary barotrauma.

Ear injury barotrauma diagnosis

Providers will do a physical exam. They may look inside your ear with an otoscope, which is a special lighted instrument that helps providers look for damage to your eardrum, infections or other problems. They may order other tests, including:

• Magnetic resonance imaging (MRI) to view your inner ear.
• Hearing test.

Pulmonary barotrauma diagnosis

In addition to doing a physical examination, providers may order chest X-rays to evaluate lung damage.

Sinus barotrauma diagnosis

Providers will do a physical examination, focusing on your ears, nose and throat. They may:

• Examine the inside of your nose with an endoscope, a small, lighted instrument.
• Order a computed tomography (CT) scan to obtain images of your sinuses.

What are barotrauma treatments?

Treatment depends on the barotrauma type. For example, you may not need any treatment for ear injury barotrauma. But lung barotrauma almost always requires treatment.

• Ear injury barotrauma: Your provider may prescribe decongestants. If you ruptured your eardrum, you might need surgery called tympanoplasty to patch your torn eardrum.
• Pulmonary barotrauma: Treatment depends on your situation. In most instances, you’ll need oxygen therapy and bed rest. If barotrauma has done serious damage to your lungs, you may need other treatment, including surgery.
• Sinus barotrauma: Providers may prescribe decongestants.

Can I prevent barotrauma?

Yes, in most cases you can prevent barotrauma:

• If you’re flying on an airplane, invest in special earplugs. Chewing gum, blowing your nose and yawning are other ways to can help protect your ears from damage caused by barometric changes.
• If you scuba dive, follow safe diving practices to avoid ear, lung and sinus barotrauma. Organizations such as the Divers Alert Network (DAN) promote dive safety with courses and information on health and safety guidelines.

What can I expect if I have barotrauma?

Your prognosis or expected outcome depends on your situation. For example, if you have airplane ear, you may not need any treatment. But if your eardrum is damaged, you may need surgery. Because these conditions vary widely, a healthcare provider is your best resource for information. They’ll tell you what you can expect.

How do I take care of myself?

Barotrauma covers a wide range of medical conditions. Some are more serious than others. Contact your healthcare provider if you’ve experienced significant air and water pressure changes that might affect your health.

A note from Cleveland Clinic

Barotrauma happens when your body can’t adapt fast enough to changes in air and/or water pressure. You may develop barotrauma while flying in an airplane or scuba diving. Barotrauma can be a serious medical issue, particularly if it affects your lungs. The good news is that planning for plane flights or diving expeditions can help protect you against barotrauma.