Barotraumatic Otitis Media

Definition : A non-infective inflammatory reaction produced in the lining of the middle ear cleft when the air pressure within it is considerably below that of the surrounding atmosphere.

Aetiology :

1. Rapid descent in non-pressurized aircraft.
2. Diver’s rapid descent
3. Pressurization in a chamber

Symptoms :

•         Increasing pain and discomfort in the ear

•         Hearing loss

•         Autophony

•         Sense of fluid in the ear

•         Tinnitus

•         Vertigo

Signs :

•         Reddening over the handle of malleus

•         Redness of the whole tympanic membrane

•         Bubbles and yellowish middle ear fluid seen through the membrane

•         Haemotympanum

•         Perforation

Treatment :

1. Unlocking- when possible

        - return to height at which tube was 

                             locked

        - decompression chamber (would be Ideal)

     2. Eustachian catheterization- if fluid is absent

     3. Myringotomy if fluid is present. Insertion of Grommet in recurrent cases.

     4. Local & systemic decongestants and Systemic antibiotics

Prevention :

1. Avoidance of flying with an upper respiratory tract infection.
2. Avoidance of sleep during descent
3. Application of decongestant nose drop before descent
4. Auto inflation by Valsalva

Insertion of grommets in recurrent cases