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Barotrauma of the Middle Ear, Sinuses, and Lung

Dongsheng Jiang, MS, MD and Juan Qiu, PhD, MD Reviewed 06/2022
 


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

    • Treatment is based on severity of symptoms.

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

    • Steroids have n...

ONGOING CARE

FOLLOW-UP RECOMMENDATIONS

  • Close follow up with physical examination until symptoms resolve

  • Audiograms and tympanometry if tympanic rupture

  • No flying or diving until complete resolution of al...

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.
2
Morgagni F, Autore A, Landolfi A, et al. P...

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

  • Otic barotrauma is common in air travel, especially among flight personnel.

  • 120 mg PO pseudoephedrine prior to flying is useful for adults.

  • Small children can equalize eustachian tube pr...

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