Causes
Symptoms of barotrauma
Diagnostics
Treatment of barotrauma
Prevention of barotrauma
Between the external auditory canal and the middle ear is the eardrum - the membrane that is the very first to perceive the vibrations of the sound wave. This makes the eardrum very sensitive to changes in atmospheric pressure and, especially, to its sudden changes. In the latter case, the integrity of the tympanic membrane is preserved due to the presence of the auditory tube - a special channel connecting the middle ear cavity with the nasal cavity, and at the same time with the environment. This anatomy makes it possible to equalize the pressure on the eardrum from both the external auditory canal and the middle ear, keeping this important membrane intact.
When there is a rapid change in external pressure, or the patency of the auditory tube is impaired, the tympanic membrane begins to experience a powerful one-sided impact from the outside, and its tear occurs - ear barotrauma.
Causes
The main causative factor of ear barotrauma is a rapid change in pressure. This can lead to:
- A sharp plunge into the water (diving) or a quick rise to its surface;
- Rapid change in height above the ground (fighter pilots, astronauts);
- Loss of cabins sealing at high altitudes;
- Shock wave during hostilities with a close burst of a projectile;
- Medical manipulations (improper use of the pressure chamber, complications in the diagnosis of the ear using the Siegle funnel, during pneumomassage of the tympanic membrane).
Barotrauma much more often occurs against the background of a violation of the patency of the auditory tube due to edema (with rhinitis or otitis media), adenoids, hypertrophy of the mucous membrane, the presence of tumors.
Symptoms of barotrauma
At the moment of receiving barotrauma, a strong blow is felt in the ear or in the head. After that, there is a pronounced ringing, noise, crackling in the ears in combination with hearing loss. The general condition of the patient may suffer, sometimes neurological symptoms develop.
Barotrauma with a slight tear of the tympanic membrane can be asymptomatic for a long time, but later symptoms of otitis media develop due to the penetration of infection in the damaged area.
Severe barotrauma, leading to a complete rupture of the tympanic membrane, is accompanied by a sharp loss of hearing, severe bleeding from the external auditory canal, dizziness, disorientation of the victim up to loss of consciousness.
Diagnostics
While maintaining consciousness in the patient, the circumstances that could cause barotrauma are studied in detail. Further, in the absence of obvious bleeding from the external auditory canal, an otoscopy or microotoscopy is performed, during which the tympanic membrane is carefully examined. In the case of barotrauma, hemorrhages are found in the thickness of this membrane, single or multiple tears. If only the inner surface of the tympanic membrane is torn, then otoscopy determines its cyanotic color with a possible horizontal level - symptoms of filling the middle ear cavity with blood.
Audiometry is done to diagnose hearing impairment.
In the absence of consciousness and the presence of severe bleeding from the external auditory arches, the diagnosis of barotrauma is obvious. Further studies to confirm the diagnosis are carried out only after the completion of resuscitation measures.
To exclude other injuries in the deeper structures of the ear, face, skull bones, brain, internal organs, X-ray, ultrasound, computed or magnetic resonance imaging is performed.
Treatment of barotrauma
In the absence of obvious tears or ruptures of the tympanic membrane, barotrauma therapy is reduced to the appointment of sedatives or sedatives, physiotherapy procedures.
In most cases, there is a violation of the integrity of the tympanic membrane, therefore, the prevention of infectious complications (otitis media, chronic purulent otitis media) comes to the fore. In this case, a toilet of the external ear is carried out and the external auditory canal is tamped with a cotton ball soaked in a solution of an antibiotic or antiseptic. A sterile bandage is applied on top. Further, symptomatic therapy is prescribed: pain relievers, anti-inflammatory, sedatives.
With significant ruptures of the tympanic membrane and the absence of chances for self-healing, various surgical interventions are used for its plastic.
Prevention of barotrauma
We keep the health of our patients in focus and advise you to adhere to the basic rules for preventing the occurrence of barotrauma:
- On air travel, sucking on candy or chewing gum causes swallowing, which improves the patency of the auditory tube;
- When taking off, landing or on steep rides, it is advisable to open your mouth a little - this helps to balance the pressure as soon as possible;
- When diving to great depths - strictly follow all safety requirements.
Well, the last thing that will help keep you healthy is the timely treatment of rhinitis, otitis media and other ENT diseases. If they are present, it is necessary to avoid conditions where there is an increased risk of barotrauma (air travel, deep-sea voyages, high and high-speed attractions, etc.).
