Did you often feel pressure in the ears or have the sensation that your ears are stuffed, especially at higher altitudes? In such a situation, did you often feel the need to ‘pop’ your ears by actions like swallowing, yawning or chewing gum? Did the condition sometimes grow so adverse as to result in bleeding from your ears? This phenomenon is known as ear barotrauma in which you might feel pressure changes in your ears.

What is Ear Barotrauma?

Ear barotrauma is a condition in which a person faces discomfort in the ears due to pressure changes. In each ear, there is a tube that connects the middle ear to the throat and the nose. It is known as the Eustachian tube which normally equalises the pressure of the middle ear to that of the outside air pressure, by maintaining equal pressure on both sides. When this tube is blocked, a person might face ear barotrauma.

Occasional ear barotrauma might occur in certain situations such as altitude changes. Although in most of the cases it is temporary in nature and is not very harmful to many people, however, if this happens frequently, it may give rise to various other complications. It’s very important to understand the differences between acute or occasional cases with that of chronic or recurring cases of ear barotrauma.

To sum up, ear barotrauma is an injury caused to the ears due to pressure changes and pressure differences between the inside and the outside of the eardrum. The eardrum separates the ear canal of the outer ear from the middle ear. Barotrauma can cause pain and discomfort in the ears due to pressure imbalances or inequalities in the ears and the environment outside.


What is Eustachian Tube?

The Eustachian tube is a canal that connects the middle ear to the nasopharynx - which comprises the upper throat and the back of the nasal cavity. The nasopharynx comprises the upper throat and the back of the nasal cavity. The Eustachian tube, also known as the auditory tube or the pharyngotympanic tube, is approximately 35 mm long and 3 mm in diameter. It maintains and equalises the pressure in the middle ear and the air pressure outside.

Most of the time, the Eustachian tube remains closed except at the time of activities like yawning, swallowing, and chewing, so as to allow air through the passage between the middle ear and the nasopharynx. You might notice a sudden feeling of blockage or stuffing in your ears if there are pressure changes in your ears while at higher altitudes. This condition is known as ear barotrauma. In such a situation, try out these activities to equalise the pressure on both sides.


What are the Functions?

The Eustachian tube is responsible for the following -

  • Pressure Equalisation - As already mentioned, the Eustachian tube equalises the pressure of the body and the outside air pressure.

  • Mucus Drainage - The Eustachian tube also drains mucus from the middle ear to prevent middle ear infections.

Otitis media or inflammation of the middle ear might affect the Eustachian tube, and children are more vulnerable to this condition.


Symptoms of Ear Barotrauma

Check out for the following common symptoms of ear barotrauma which might occur in mild to moderate cases -

  • General ear discomfort

  • Dizziness

  • Stuffiness or fullness in the ears

  • Slight hearing difficulties or mild hearing loss

If this continues for long and goes without proper treatment, or if the case is severe, then the symptoms might be intensified, with the following additional ones -

  • Ear pain

  • Nose bleeding

  • Eardrum injury

  • Moderate to severe hearing loss

  • Feeling of great pressure in the ears, as if you were underwater

However, generally, the symptoms would go away if you treat the condition on time. Hearing loss caused due to ear barotrauma is almost always temporary and reversible in nature. But the earlier you indulge in a proper hearing loss treatment, the better and faster will be the recovery.


Causes of Ear Barotrauma

One of the main causes of ear barotrauma is the blockage of the Eustachian tube which helps to restore equilibrium during pressure changes, thereby balancing air pressure on both sides of the eardrum. Eustachian tube blockages might occur during activities or events such as -

  • Scuba diving

  • Hiking

  • Ascent and descent of an aeroplane - a condition known as airplane ear

  • Driving on the mountains

Diving is the most common cause of ear barotrauma because while you are underwater, you would be experiencing much more pressure in your ears than it that on land. Divers must take enough ear protection before diving because while you are in the range of the first 14 feet of the dive, you are greatly vulnerable to ear injuries. The pressure underwater changes drastically, and therefore divers are advised to descend slowly while diving towards the floor or the sea-bed. Middle ear barotrauma is the most common condition among divers.

However, apart from pressure changes, there are certain risk factors as well which can cause Eustachian tube blockages. For example, a person with allergies or colds or other active infections might have a greater risk of experiencing ear barotrauma. Also, infants and young children are at a greater risk because a child’s Eustachian tube is smaller in length and is positioned differently than that in an adult, which results in Eustachian tube blockages more easily.


How to Treat Ear Barotrauma?

Often clearing the other end (the nasopharynx part of the Eustachian tube) helps equalise the pressure on both the sides of the eardrum. Here are some common activities to do so -

  • Yawning

  • Chewing gum

  • Swallowing

  • Practising breathing exercises

  • Taking antihistamines


What are the Potential Complications?

In some cases, ear barotrauma might cause eardrum rupture when there is a huge difference in the pressure on either side. A ruptured eardrum might take up to two months to heal. It might cause a temporary hearing loss which can be treated easily.

We have covered a separate blog on Ruptured Eardrum, do check it out: https://hearingplus.in/ourblog/Perforated-Eardrum-Symptoms-Causes-and-Consequences/

Apart from an eardrum rup[ture, the other complications that might occur due to ear barotrauma include -

  • Ear infections

  • Hearing loss

  • Recurring pain

  • Vertigo or dizziness

  • Bleeding from nose or ears

Consult an audiologist immediately if symptoms persist. If you notice any hearing changes, don’t delay a hearing loss treatment.


How to Prevent it?

  • Descend slowly while diving

  • Yawning, chewing gum or swallowing while you feel that you might get ear barotrauma might help prevent it or at least relieve the symptoms

  • Avoid wearing earplugs while diving or in a flight

  • Exhale through your nose while going up at higher altitudes

A little care can make a huge difference.