This information is provided by the American Speech-Language-Hearing Association (ASHA).

Barotrauma, also referred to as aero-otitis, is the result of injury to the middle ear caused by a significant difference between air pressure in the middle ear and the atmospheric pressure surrounding it. This difference can occur during travel on airplanes or submarines, while working in tunnels, and at high altitudes in the mountains.

Barotrauma occurs when the Eustachian tube (the tube that connects the middle ear to the back of the throat) does not open and close freely during changes in air pressure, usually in the presence of a cold. Colds inflame the tissue at the mouth of the Eustachian tube and prevent it from opening and closing properly. At higher altitudes, the middle ear contains less air than at lower altitudes where the surrounding outside pressure is greater and the air is more dense. Under normal circumstances, as the atmospheric pressure increases during descent, more air enters through the Eustachian tube and equalizes the air pressure in the middle ear to atmospheric pressure. If air does not enter, the difference in pressure between the outside and the middle ear build up, forces the eardrum inward. and results in pain. Sometimes, clear fluid collects in the middle ear.

Depending on the amount and location of damage, hearing loss may be temporary or permanent, greater in the high or low frequencies, may fluctuate or remain stable, and range in severity. Some people also experience dizziness and tinnitus (ringing, humming, or buzzing sound).

The best way to avoid barotrauma is to avoid activities that may result in significant air pressure changes when you have a cold. If you cannot avoid such activity, try to open and close your Eustachian tube as often as possible during pressure changes. Continuous swallowing, chewing gum, drinking, yawning, moving the jaw around, and pinching the nostrils closed while blowing will force the Eustachian tube open. Referral to a physician may be needed for medication such as inhalants, antihistamines, or decongestants to reduce inflammation around the Eustachian tube and fluid in the middle ear space.

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