HEALTH BEAT, Tuesday, July 21, 1998

Barotrauma -- Pressure-related ear and sinus pain

Combine an airplane trip with a stuffed-up nose and you have the makings for an unpleasant travel experience. Changes in air pressure can lead to pain in the ears and sinuses, a condition called barotrauma.

"Under normal circumstances, our bodies are able to equalize differences in air pressure that occur between the middle ear and the environment," explains Dr. Jeff Altman, co-director of the Hall Health Travel Clinic at the University of Washington and clinical assistant professor of family medicine. "Yet if a blockage occurs, say due to a cold, the air pressure on either side of the ear drum becomes uneven. It can be a truly painful experience."

Barotrauma can cause pain; slight, temporary hearing loss; and, in extreme cases, rupture of the ear drum. Yet Altman notes that taking some precautionary measures can help people avoid or reduce barotrauma.

Differences in air pressure can occur during airplane flights, traveling over mountain passes, scuba diving or traveling by undersea railroad tunnels. Persons who are suffering from allergies or colds or who have experienced difficulties in the past with ear or sinus pressure during altitude change are at risk for barotrauma.

To prevent pressure-related pain, Altman recommends taking 12-hour pseudoephedrine (Sudafed) starting about 48 hours before any expected air pressure change. This decongestant will help shrink swollen tissues.

"When traveling by plane, it's important to take into consideration how long you will be traveling and how many stops you may be making, to make sure the medication is working when the plane descends," Altman notes.

For immediate relief of pain associated with air pressure, use a Benzedrex inhaler. This should be used at the first sign of increased pressure in the sinuses or ears and can be repeated as often as needed.

Staying well hydrated is also important to help keep the nose and throat clear. Altman advises drinking non-alcoholic liquids every hour. And when traveling by plane, carry a water bottle to make sure fluids are easily at hand.

During an airplane descent, it can be helpful to swallow frequently, chew gum or suck on candy. Another technique is to gently blow air out of the nose while the mouth is closed and nose is slightly pinched.

"Barotrauma rarely causes long-term problems," Altman notes. "If you suffer discomfort that lasts for more than a day following an airplane flight or other air pressure change, it's advisable to see your physician."

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