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| Barotrauma, Definition, Symptoms, Causes, Diagnosis, Treatment, Prevention, Complications |
Barotrauma is an injury that occurs due to sudden changes in air pressure. This condition is often experienced by a diver or a person who regularly travels by airplane.
Barotrauma is characterized by ear congestion due to differences in air pressure inside and outside the ear. Barotrauma generally occurs in the ear, but can also occur in the lungs or digestive tract.
Causes of Barotrauma
Barotrauma is caused by differences in air pressure inside and outside the ear. Barotrauma often occurs when planes take off and land.
Under these conditions, the air pressure in the aircraft cabin changes rapidly. If the ear does not adapt quickly to balance the air pressure inside the ear, then barotrauma can occur.
Barotrauma can also occur when doing scuba diving activities. The deeper a person dives, the higher the pressure received. If you're not good at balancing the pressure in your ear and you're still forcing yourself to dive, this pressure can rupture the eardrum.
Apart from flying and diving activities, barotrauma can also occur due to the following conditions:
- Suffered an ear injury from the explosion
- Undergoing hyperbaric oxygen treatment therapy
- Take a hike to the top of the mountain
- Drive a vehicle on hills or mountains
- Ride or get off the elevator from or to a higher floor
The pressure inside the ear will adjust to the pressure outside through the tube connected to the nose (Eustachian tube). If the Eustachian tube is blocked, for example when you have a cold or have otitis media, the risk of barotrauma will increase.
Lung barotrauma
In addition to attacking the ears, barotrauma can also attack the lungs and digestive tract. Pulmonary barotrauma can occur while diving.
Pulmonary barotrauma is also at risk for patients who use a breathing apparatus (ventilator) while being treated in the ICU. Therefore, before using a ventilator, discuss with your doctor about the benefits and risks.
Symptoms of Barotrauma
The initial symptoms of barotrauma are mild and can be treated simply by swallowing or chewing. Early symptoms of barotrauma are:
- Mild ear pain
- A feeling of fullness and discomfort in one or both ears
- Decreased hearing
- Dizzy
If left unchecked and pressure changes continue to occur, more serious barotrauma symptoms can appear, including:
- Severe pain in the ear
- Ears ringing
- Vomit
- Vertigo
- Bleeding or discharge from the ear
- Hearing loss
In contrast to barotrauma to the ear, barotrauma to the lungs is characterized by hoarseness, chest pain, and shortness of breath. Meanwhile, the symptoms of barotrauma that occur in the digestive tract include abdominal pain and cramps, and flatulence.
When to go to the doctor
If you experience serious symptoms of ear barotrauma, consult a doctor immediately. Handling needs to be done immediately to prevent further damage to hearing.
Immediately contact medical help or visit the nearest hospital, if symptoms of barotrauma appear after diving, especially if symptoms get worse or the following symptoms occur:
- Coughing up blood
- Hard to breathe
- Paralysis of the arms or legs
- Lost balance
- Decreased consciousness
If the above symptoms appear, visit a hospital that has hyperbaric oxygen therapy facilities, because you may have decompression sickness.
If you have allergies, a cold, or have an ear infection, and are planning to travel by plane in the near future, it's best to talk to your doctor first. Likewise if you plan to dive.
For pilots or crew members, see a doctor for a medical check-up once a year. Pilots aged 40 years and over are required to undergo a medical examination every 6 months, to prevent flight-related diseases, such as barotrauma, and to maintain passenger safety.
Likewise with professional divers, it is recommended to undergo a medical check-up at least once a year, in addition to a health check carried out before diving.
Diagnosis of Barotrauma
Ear barotrauma can be felt by sufferers themselves when diving or traveling by airplane. If the symptoms do not improve for a few days, then do the examination to the doctor.
The doctor will ask about the patient's symptoms and medical history. The doctor will also examine the patient's ear using an otoscope, to see conditions inside the ear canal.
If necessary, the doctor will perform a follow-up examination to confirm the diagnosis and the consequences. The types of follow-up examinations carried out are:
- Hearing test, to check hearing function and detect damage to the ear
- X-rays, to detect accumulations of fluid or air in body parts, such as sinuses or abdominal cavity
- CT scan or MRI, to check the condition of organs suspected of experiencing barotrauma, such as the lungs or digestive tract
Barotrauma Treatment
Barotrauma usually heals on its own without special treatment. If you experience pain or discomfort in your ears during the flight, you can suck on candy or chew gum. If you don't have candy, try yawning or swallowing.
If that doesn't work, pinch your nose, inhale through your mouth, and try to keep exhaling through your nose slowly.
Ear barotrauma that occurs when diving can also be treated with special techniques. Make sure you have received training and certificates before diving.
Drugs
If the simple steps above are not effective and the symptoms do not go away, then medical treatment needs to be done. One of them is with medicine. Some types of drugs that doctors can give, among others:
- Decongestants
- Pain reliever
- Antihistamines
Operation
Surgery is performed on severe barotrauma. This procedure is done by implanting a special instrument such as a tube in the eardrum. This cylindrical tube serves to circulate air into the inner ear so that the pressure inside the ear equals the pressure outside.
Another surgical method that can be performed by an ENT doctor is to make a small incision in the eardrum (myringotomy).
Management of barotrauma in infants and children
If you're taking your baby on a flight and your baby is showing symptoms of barotrauma, try feeding or drinking to ease the symptoms. Also give a pacifier to deal with the pain and anxiety he is experiencing.
If symptoms do not improve, the doctor will prescribe ear drops to help relieve pain in the child's ear.
Barotrauma Complications
Barotrauma, especially the ear, is usually transient and rarely causes complications. However, complications can still occur, especially in severe barotrauma. Complications that can arise include:
- Ear infection
- Broken eardrum
- Permanent hearing loss
- Vertigo
- Bleeding from ears and nose
Pulmonary barotrauma can also cause dangerous complications, especially in patients who already suffer from impaired lung function. Some of the complications that can arise are:
- Cardiac tamponade
- Pulmonary embolism
- Pneumothorax
- Pneumomediastinum, which is a buildup of air in the center of the chest, causing chest pain, difficulty swallowing, and voice changes
Barotrauma Prevention
The main way to prevent ear barotrauma is to keep the Eustachian tube open. Ways that can be done include:
- Take medicine
- If you have a cold, use a decongestant about 1 hour before your flight. In addition, antihistamines can also be used. However, first consult with your doctor about this.
- Using earplugs (earplugs)
- Special earplugs for air travel can be used to slow pressure changes and give the ear time to adjust.
Prevention of in-flight barotrauma
If your ears hurt during flight, try these ways to relieve pain and prevent barotrauma:
- Don't sleep when the plane is about to land and try to yawn or swallow to relieve stuffy ears.
- Consume gum or chew gum, as chewing and swallowing can help control air pressure in the ear.
- Drink during flight to keep the Eustachian tube open and help loosen mucus in the respiratory tract.
- Inhale, then pinch your nose with your fingers and close your mouth, then exhale slowly through your closed nose.
If you're bringing your baby on a flight, make sure he doesn't fall asleep when the plane lands, by giving him a pacifier to keep him awake.
While the best way to prevent barotrauma while diving is to apply good diving techniques. You can learn the correct diving technique through certified training.
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