What is Barotrauma?
While you may not have heard the term before, most of us have experienced barotrauma in our ears. Barotrauma is the feeling that you experience when you fly on airplanes, go for a drive through the mountains, or ride an elevator in a tall building.
Causes of Barotrauma
In order to understand what causes Barotrauma, you must first understand some quick ear anatomy. Your ‘middle’ ear is the space that sits directly behind the ear drum. It is responsible for transmitting the sound energy from the outside world to your ‘inner’ ear, where the hearing organ, the cochlea, and hearing nerves are located. In a healthy ear, this middle ear space is filled with air, which provides optimal conditions for sound transmission. In order to maintain this air-filled status, the middle ear relies on the Eustachian tube.
The Eustachian tubes connect the middle ear to a portion of the throat that sits behind the nasal cavity known as the nasopharynx. At rest, the Eustachian tubes remain closed, which means the middle ear is effectively ‘sealed off’ from the environment around you. Whenever you do things like swallow or yawn the Eustachian tubes open and break that seal. Thus allowing the pressure within your middle ear to equalize with the pressure of the surrounding environment.
Under normal conditions, you don’t notice when that seal is broken because the pressure in your middle ear and the air pressure of the environment around you is relatively similar. When you are in situations where the air pressure around you changes rapidly—like during an airplane landing or descending down a mountain road—the pressure difference in your middle ear is much greater. This pressure difference causes stretching of your ear drum as it is either pushed out or retracted in, which can lead to that uncomfortable feeling that most of us have experienced.
Preventing and Treating Barotrauma
The goal of preventing and/or treating barotrauma is to get your Eustachian tubes to open, thus allowing for equalization of the pressure in your middle ear. Your Eustachian tubes open during normal daily activities such as chewing and swallowing—so don’t discredit the age-old chewing gum trick that your mom taught you. It really works! It leads to more chewing and more swallowing which, as you now know, leads to Eustachian tube opening. If you can make yourself yawn, try that too.
If these don’t work for you, there are a group of over-the-counter medications known as ‘decongestants’ that may help. Decongestants act by reducing the amount of tissue swelling in your nasal cavity and nasopharynx to help promote opening of your Eustachian tubes. These medications are commonly available as nasal sprays (e.g. Afrin) and oral tablets (e.g. SudaFed) formulations.
If you’re having trouble clearing your ears, we’re here to help
Dr. Eric Eisen, an ENT surgeon at Proliance Eastside ENT, typically recommends the nasal sprays over the oral medications because the effect is more localized to the area we are trying to treat and has less of an effect on your overall body. As always, you should consult with your primary care provider before taking these medications, especially if you have issues with high blood pressure.
The providers at Proliance Surgeons Eastside ENT have extensive experience evaluating and treating ear problems both medically and surgically. There are various oral and nasal medications, and other options to help you. If your quality of life is negatively affected by ear problems, call us today to set up an appointment.