Otic barotrauma

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Background

  • Also known as "ear squeeze" during scuba diving or air flight

Clinical Features

Middle Ear

  • Results from inability to equalize middle ear pressure
  • Pain, fullness, vertigo, conductive hearing loss, TM rupture

Inner Ear

  • Results from forceful Valsalva against an occluded eustachian tube
    • Pressure difference between middle ear and inner ear can rupture oval or round window
  • Sudden onset of sensorineural hearing loss, tinnitus, severe vertigo

Differential Diagnosis

Diving Emergencies

Workup

Management

Middle Ear

  • decongestants
  • consider abx if TM ruptured

Inner Ear

  • Head of bed up
  • no nose blowing
  • antivertigo medications
  • ENT consult

Disposition

See Also

External Links

Sources