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Barotrauma of the Middle Ear, Sinuses, and Lung

Jason A. Burchett, DO and J. David Honeycutt, MD Reviewed 06/2018
 


BASICS

DESCRIPTION

  • Barotrauma is tissue damage resulting from the direct effects of pressure changes or imbalances between ambient pressure and pressure within an enclosed body cavity.

  • Body cavities at ...

DIAGNOSIS

HISTORY

  • History of high-risk activity

  • Pulmonary barotrauma: Ask about scuba diving, mechanical ventilation, hyperbaric oxygen therapy, air travel with preexisting lung disease:

    • Chest pain

    • Dyspne...

TREATMENT

GENERAL MEASURES

  • For inner ear barotrauma

    • Bed rest with head elevated (45 degrees) to avoid leakage of perilymph

    • Trial of high-dose steroids 250 mg prednisolone for 3 days with a taper for tota...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • No flying or diving until complete resolution of all signs and symptoms and Valsalva maneuver succeeds in equalizing pressure

  • Complete bed rest for inner ear barot...

REFERENCES

1
Sutherasan Y, Vargas M, Pelosi P. Protective mechanical ventilation in the non-injured lung: review and meta-analysis. Crit Care.  2014;18(2):211. {L-End} [View Abstract on OvidMedli...

ADDITIONAL READING

Klokker M, Vesterhauge S, Jansen EC. Pressure-equalizing earplugs do not prevent barotrauma on descent from 8000 ft cabin altitude. Aviat Space Environ Med.  2005;76(11):1079–1...

SEE ALSO

Algorithm: Ear Pain/Otalgia 

CODES

ICD10

  • T70.0XXA Otitic barotrauma, initial encounter

  • T70.1XXA Sinus barotrauma, initial encounter

  • T70.29XA Other effects of high altitude, initial encounter

  • T70.9XXA Effect of air pressure and water ...

CLINICAL PEARLS

  • Small children can equalize eustachian tube pressure by breastfeeding or sucking on bottles or pacifiers. Crying also serves as autoinflation.

  • Pulmonary barotrauma is the second leading...

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