Overview of Barotrauma

Barotrauma refers to injuries caused by a pressure difference between inside and outside of your body. It mostly happens during flights and scuba diving.

Barotrauma (فَضَائي يا آبي دَباو ميں تبديلي کي وَجَہ سے زَخَم مَثلاً کان کا پَردَہ پھَٹ جانا/ Fhazai ya Abi Dabao ki Wajah se Kaan ka Pardah Phat Jana) refers to injuries caused by pressure difference between inside and outside of your body. It mostly happens due to high-pressure water or air, such as during flights and scuba diving. The most common type of barotrauma is the injury of the ears.
Barotrauma is the most common medical condition experienced by air travellers and scuba divers. Barotrauma of the lungs is most common in scuba divers who hold their breath for a longer time. Symptoms of barotrauma vary and depend on the organ it affects. These symptoms mostly appear during pressure and after that disappear.

Occurrence of Barotrauma

Barotrauma mostly occurs in-flight travellers and scuba divers. It can occur in people of all ages. However, in children, its symptoms are more severe. As per research, recently in COVID-19 patients increased incidence of pulmonary barotrauma has been recorded due to invasive mechanical ventilation.


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Signs and Symptoms of Barotrauma

Signs and symptoms of barotrauma depend on the type of organ affected. Some common signs and symptoms include:


  • Pulmonary Barotrauma

  • Hoarse voice
  • Coughing with blood
  • Breath shortness
  • Chest pain
  • Sinus Barotrauma

  • Congestion in nose
  • Bloody nose
  • Headaches
  • Facial pain
  • Eye Barotrauma

  • Soreness
  • Loss of vision
  • Mask Barotrauma

  • Sore and bloodshot eyes
  • Bruised face
  • Dental Barotrauma

  • Toothache
  • Damaged teeth


Types of Barotrauma

There are different types of barotrauma depending on the body part it affects such as:

  • Ear barotrauma (ear squeeze)
  • Pulmonary barotrauma (lungs injury due to pressure difference)
  • Sinus barotrauma (sinus injury)
  • Eye barotrauma (eye injury)
  • Mask barotrauma (injury due to mask)
  • Dental barotrauma (dental injury)
  • Gastrointestinal barotrauma (gut injury)
  • Decompression sickness or generalized barotrauma
  • Primary blast barotrauma
  • Medically induced barotrauma (due to medical procedures)
  • Self-induced barotrauma


Causes of Barotrauma

The most common cause of barotrauma is the difference in pressure while diving or flight travelling. Other causes are:


  • Ear barotrauma occurs while descending during an aeroplane flight or scuba diving. Due to pressure change, a vacuum is filled inside the middle ear that pulls the eardrum inward and causes muffled voices.
  • Lung barotrauma also occurs due to pressure differences. Vacuum is filled inside the lungs that cause the rupture of tissues.
  • Decompression sickness or generalized barotrauma occurs in scuba or deep-sea divers. It occurs due to the intake of oxygen and nitrogen during breathing. Oxygen is used by the body while nitrogen is dissolved in the blood causing sickness.
  • The exact reason for medically induced barotrauma is unknown. However, evidence suggested that ventilation creates increased pressure inside the alveoli that causes inflammation, rupture and bleeding into the extra alveolar spaces.
  • Primary blast injuries are caused by the overpressure of shock waves produced by explosions. These waves mostly affect the air-containing organs such as the brainlungsear and gastrointestinal system.



Risk Factors of Barotrauma

Certain Behaviors can increase the risk of getting barotrauma. These include:

Any issue that blocks the eustachian tube increases the risk of you experiencing barotrauma. People who have allergies and active infections are more likely to encounter barotrauma.
Infants and small children are also at risk of this condition. As their eustachian tube is smaller and placed differently than an adult’s and gets blocked easily.

Barotrauma Health Complications

Ear barotrauma is usually temporary. However, complications might emerge in some people, especially in chronic cases. This condition if left untreated may cause:

  • Ear Infections
  • Hearing loss
  • Ruptured Eardrum
  • Chronic Dizziness and feeling of unbalance (vertigo)
  • Bleeding from nose or ears


You should contact your doctor if you feel persistent ear pain or decreased hearing. Recurring symptoms can be a sign of chronic ear barotrauma.




You can decrease your risk of experiencing barotrauma by taking antihistamines or decongestants before you fly on a plane or you go scuba diving. Other measures that you can take are:

  • Swallow yawn and chew when you feel the symptoms of barotrauma
  • Exhale through your nose during an ascent in altitude
  • Avoid earring earplugs while driving or flying
  • Descend slowly while driving


Mostly barotrauma injuries recover quickly without any complications.



In mild cases of barotrauma, you can examine yourself especially in the case of ear barotrauma.

  • If you are uncertain about symptoms consult the doctor. The doctor will use a device called an osteotomy to see if the eardrum is pulled inward. The perforated and fluid-filled eardrum can be diagnosed by this device.

For barotrauma, laboratory tests are not recommended. However, your doctor may recommend some imaging tests (X-ray, CT scan or MRI) to confirm other complications.


Treatment of Barotrauma | When to Consult a Doctor

Treatment options for barotrauma include:

  1. Treatment of Ear Barotrauma

If you experience barotrauma symptoms during flight, you can relive these symptoms by: 

  • Chewing gum or hard candy.
  • Yawning and swallowing frequently.
  • Pinching your nose closed, 
  • inhale through your mouth

In most serious cases of barotrauma such as injury of eyes, nose or throat decongestants are used for the treatment. In this procedure, a small incision is created in the eardrum to equalize pressure and drain fluid.

To treat a perforated eardrum, surgery is performed

  1. Treatment of Other Types of Barotrauma

  • Most barotrauma injuries such as Sinus barotrauma, Mask barotrauma, Dental barotrauma and Decompression sickness or generalized barotrauma need only symptomatic treatment. 
  • While some other serious injuries such as lungs, brain and GIT are life-threatening and require immediate and proper treatment such as chest decompression for patients with pneumothorax.


If you feel dizziness after a flight or diving consult an audiologist via Healthwire for diagnosis and treatment. If you have severe symptoms such as bleeding or fluid seek immediate medical care.