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 a feeling of tightness in the ear due to the difference 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 inside the aircraft cabin changes rapidly. If the ear does not quickly adapt to equalize air pressure inside the ear, barotrauma can occur.

Barotrauma can also occur when doing scuba diving . The deeper a person dives, the pressure received will be higher. If you're not good at balancing the pressure in your ear and still insist on diving, this pressure can rupture the eardrum .

In addition to flight and diving activities, barotrauma can also occur due to the following conditions:

  • Suffered an ear injury from the explosion
  • Undergoing hyperbaric oxygen therapy
  • Take a hike to the top of the mountain
  • Drive a vehicle on hills or mountains
  • Ride or descend the elevator from or to a higher floor

The pressure inside the ear will adjust to the pressure outside through the channel 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.

Barotrauma is also more at risk for someone whose family has had barotrauma.

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.

Barotrauma symptoms

The initial symptoms of barotrauma are mild and can be treated in a simple way, namely by swallowing or chewing. Early symptoms of barotrauma are:

  • Mild ear pain
  • A feeling of fullness and discomfort in one or both ears
  • Reduced hearing
  • Dizzy

If left unchecked and pressure changes continue to occur, more serious barotrauma symptoms may appear, including:

  • Severe pain in the ear
  • Buzzing ears
  • Vomit
  • Vertigo
  • Bleeding or discharge from the ear
  • Hearing loss

Unlike ear barotrauma, lung barotrauma is characterized by hoarseness, chest pain , and shortness of breath. Meanwhile, symptoms of barotrauma that occur in the digestive tract include abdominal pain and cramps, and flatulence .

When to see a doctor

If you feel 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 could be experiencing decompression sickness .

If you are allergic, have a cold, or suffer from an ear infection, and plan to travel by airplane in the near future, you should consult 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 health check 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 that is carried out before diving.

Diagnostics of Barotrauma

Ear barotrauma can be felt by the sufferer when diving or traveling by airplane. If the symptoms do not improve for several days, then do an 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 the condition in the ear canal.

If necessary, the doctor will carry out further examinations to confirm the diagnosis and the resulting 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 having barotrauma, for example the lungs or digestive tract

Barotrauma Treatment

Barotrauma usually heals on its own without special treatment. If you experience pain or discomfort in your ear 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, then pinch your nose, inhale through your mouth, and try to keep exhaling slowly through your nose.

Ear barotrauma that occurs when diving can also be overcome with special techniques. Make sure you have received training and certificates before doing diving activities.


If the simple steps above are not effective and the symptoms do not go away, medical treatment is necessary. One of them is with medication. Several types of drugs that doctors can give include:

  • Decongestants
  • Pain relievers
  • Antihistamines


The operation is performed in severe barotrauma. This action is performed by implanting a special device such as a tube in the eardrum. This cylindrical tube functions to circulate air into the inner ear so that the pressure inside the ear is the same as 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 a baby on a flight and the baby shows signs of barotrauma, try giving him something to eat or drink to relieve the symptoms. Also give him 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 temporary 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 effort to prevent ear barotrauma is to keep the Eustachian tube open. Ways that can be done include:

  • Take medication
    If you have a cold, use a decongestant about 1 hour before the flight. In addition, antihistamines can also be used. However, first consult with your doctor about this.
  • Using earplugs Special earplugs
    for air travel can be used to slow pressure changes and give the ear time to adjust.

Barotrauma prevention in flight

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 take your baby on a flight, make sure he doesn't fall asleep when the plane lands, one of which is by giving him a pacifier to keep him awake.

While the best effort to prevent barotrauma when diving is to apply good diving techniques. You can learn the correct diving technique through certified training.

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