Otic barotrauma: Difference between revisions

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====Middle Ear====
====Middle Ear====
*Results from inability to equalize middle ear pressure
*Results from inability to equalize middle ear pressure
*Pain, fullness, vertigo, conductive hearing loss, TM rupture
*[[earache|Pain]], fullness, [[vertigo]], conductive [[hearing loss]], [[TM rupture]]


====Inner Ear====
====Inner Ear====
*Results from forceful valsalva against an occluded eustachian tube, or rapid descent in diving or aviation
*Results from forceful valsalva against an occluded eustachian tube, or rapid descent in diving or aviation
**Pressure difference between middle ear and inner ear can rupture oval or round window
**Pressure difference between middle ear and inner ear can rupture oval or round window
*Sudden onset of sensorineural hearing loss, tinnitus, severe vertigo
*Sudden onset of sensorineural [[hearing loss]], [[tinnitus]], severe [[vertigo]]
*Must be lacking in any other neurologic signs (otherwise consider infarction)
*Must be lacking in any other neurologic signs (otherwise consider infarction)


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====Middle Ear====
====Middle Ear====
*Decongestants
*Decongestants
*Consider [[antibiotics]] if [[typmanic membrane ruptured]]
*Consider [[antibiotics]] if [[tympanic membrane rupture]]
*Urgent audiology required if sensorineural hearing loss, rather than conductive hearing loss
*Urgent audiology required if sensorineural hearing loss, rather than conductive hearing loss


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*Elevate head of bed
*Elevate head of bed
*Advise patient to not blow nose
*Advise patient to not blow nose
*Antivertigo medications
*Antivertigo medications (e.g. [[meclizine]])
*ENT consult
*ENT consult



Revision as of 21:35, 28 September 2019

Background

  • Also known as "ear squeeze" - generally seen during scuba diving or air travel

Clinical Features

Middle Ear

Inner Ear

  • Results from forceful valsalva against an occluded eustachian tube, or rapid descent in diving or aviation
    • Pressure difference between middle ear and inner ear can rupture oval or round window
  • Sudden onset of sensorineural hearing loss, tinnitus, severe vertigo
  • Must be lacking in any other neurologic signs (otherwise consider infarction)

Differential Diagnosis

Diving Emergencies

Ear Diagnoses

External

Internal

Inner/vestibular

Barotrauma Types

Evaluation

  • Generally clinical
  • Webber and Rinne for middle ear barotrauma
    • Conductive hearing loss expected

Management

Middle Ear

Inner Ear

  • Elevate head of bed
  • Advise patient to not blow nose
  • Antivertigo medications (e.g. meclizine)
  • ENT consult

Disposition

  • Generally may be discharged
  • Resolution usually in 5-7 days, but can take up to 2 weeks

See Also

External Links

References