Barotitis: A Comprehensive Review
Introduction
Barotitis is a condition in which the middle ear is exposed to a significant change in pressure. It is most commonly experienced by divers, pilots, and astronauts, but can also be caused by flying in an airplane, riding in an elevator, or other episodes of rapid pressure change. The condition is generally short-lived and does not cause any lasting effects, but it can cause a range of symptoms from mild discomfort to severe pain and hearing loss. This paper provides a comprehensive overview of the causes, symptoms, diagnosis, and management of barotitis.
Causes
Barotitis is caused by a rapid pressure change in the middle ear. In diving, this is usually caused by a rapid descent, as the air pressure in the middle ear must increase to match the pressure of the surrounding water. In aviation, it may be caused by rapid altitude changes or changes in air pressure in the cabin. Other causes of rapid pressure change in the middle ear include riding in an elevator or other rapid ascent or descent.
Symptoms
The most common symptom of barotitis is a feeling of fullness or pressure in the ears. This may be accompanied by pain, ringing in the ears (tinnitus), or a muffled or distorted hearing. In more severe cases, barotitis can cause hearing loss due to damage to the eardrum or middle ear structures.
Diagnosis
Barotitis is usually diagnosed based on a patient’s history and symptoms. If the patient is a diver or pilot, a history of rapid descent or ascent is typically sufficient to make the diagnosis. A physical examination of the ear may also be performed to look for signs of ear trauma or infection.
Management
Most cases of barotitis can be managed with conservative measures such as rest, over-the-counter pain medications, and avoiding activities that involve rapid pressure changes. If the condition is severe, a physician may prescribe a short course of antibiotics or steroids to reduce inflammation. In cases of hearing loss, a hearing aid may be recommended.
Conclusion
Barotitis is a condition caused by a rapid change in air pressure in the middle ear. It is most commonly experienced by divers, pilots, and astronauts, but can also be caused by other episodes of rapid pressure change. The most common symptom is a feeling of fullness or pressure in the ears, which may be accompanied by pain, tinnitus, or hearing loss. Most cases can be managed with conservative measures, but in more severe cases a physician may prescribe antibiotics or steroids to reduce inflammation.
References
Lane, S. D., & Kinser, C. (2015). Barotrauma and decompression sickness. In C. D. Bluestone (Ed.), Pediatric otolaryngology (pp. 843-854). Philadelphia: Saunders.
Mack, M. (2019). Barotitis. In StatPearls. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK539781/
Walker, C. (2018). Barotitis. In Merck Manual Consumer Version. Retrieved from https://www.merckmanuals.com/home/ear,-nose,-and-throat-disorders/ear-disorders/barotitis