Barotrauma

Introduction Cases of barotrauma include temporary blockage of the Eustachian tube and swelling of the eardrum due to sudden changes in air pressure. This disease usually occurs on the way to travel by air. Negative pressure in the tympanic cavity can cause vasodilatation of the submucosal tissue, causing leakage of serum, or even bleeding, forming middle ear effusion or blood accumulation. The tympanic membrane itself may increase with the negative pressure of the middle ear, and may cause invagination, congestion, mucosal layer and The fibrous layer is peeled off and even perforated. Therefore, the performance of sudden feelings of ear nausea, tinnitus, headache, dizziness and other symptoms. The lighter ones only feel the ear suffocation and healed after a few hours. In severe cases, earache, tinnitus and suction loss are obvious, and it can be restored in the future. If the tympanic effusion and blood accumulation are not easy to absorb, it will last for several days. In some cases, the tympanic membrane can be congested, and the tympanic membrane can be perforated. After repeated injuries, the tympanic membrane is often invaginated, the turbidity is thickened, the activity is poor, and the vocal tract is transmitted.

Cause

When the aircraft rises, the external air pressure decreases, and the air pressure in the drum chamber is relatively high to form a positive pressure. When the temperature rises by about 60 m (equivalent to 0.7 KPa), mild ear swelling can be felt and the tympanic membrane expands outward. With the increase of height, the sense of ear swelling and tympanic swelling are more obvious, and hearing loss occurs. When it rises to 150m (pressure reduction 2.0KPa), the sound of "click" can be heard in the ear, and the sound of the eustachian tube is rushed out of the tympanic gas. The pressure in the tympanic chamber is balanced with the external air pressure, and the ear symptoms disappear. When the temperature continues to rise, the above phenomenon can be repeated periodically.

When the aircraft descends, the external air pressure increases continuously, and the air pressure in the drum chamber is relatively lowered to form a negative pressure, and the tympanic membrane is invaded. As the height continues to decrease, the negative pressure in the drum chamber increases. The tympanic membrane is invaginated, and there is a feeling of pressure on the ear and hearing impairment. Due to the one-way flap function of the eustachian tube, the outside air can not automatically enter the tympanic cavity. Only when the swallowing action is performed, the eustachian tube can be opened, the air pressure inside and outside the drum is balanced, the tympanic membrane is reset, and the symptoms disappear. If the eustachian tube cannot be opened in time, the outside air can not enter the tympanic cavity, and the negative pressure in the tympanic chamber increases continuously, which will cause the middle ear pressure injury. When the negative pressure in the tympanic chamber reaches 6.7-8.0KPa, the ear has a painful feeling. When the negative pressure reaches 10.7 to 12.0 KPa, when the negative pressure in the drum chamber exceeds 13.3 KPa, tympanic effusion may occur and even the tympanic membrane may rupture.

The normal human eustachian tube is opened several times per minute and can be opened every 5 seconds during sleep. If the flight drops by 15m per second, no damage will occur. In particular, the air pressure in the closed cabin is slowly mutated, so that the middle ear pressure is not damaged. However, when the distance from the ground is lower, the descending speed is too fast, and a large air pressure difference occurs in a short time. If there is no active ventilation, the middle ear pressure is likely to occur. When diving, the tympanic membrane may be ruptured due to the failure to blow the eustachian tube by itself to restore the balance between the middle ear pressure and the external pressure.

Nasal and nasopharyngeal such as acute and chronic rhinitis, acute and chronic tonsillitis, adenoid hypertrophy, nasal allergic diseases, nasopharyngeal tumors, pharyngeal tendon, mandibular joint disease and malocclusion, etc., can affect the eustachian tube Ventilation is an important factor in the development of barium-induced middle ear injuries. Beginners flying, often because of high concentration of attention, is not sensitive to pressure in the ear, forget to make swallowing action, such as falling too fast, often causing middle ear pressure injury. Airborne casualties who fall asleep or stun are also susceptible to such injuries.

an examination

Differential diagnosis

Differential diagnosis of barotrauma:

Sinus pressure injury: When the sinus air pressure is flying or diving, the external air pressure changes drastically, and the air pressure in the sinus and the outside air pressure cannot be balanced, so that the sinus mucosa is hyperemia and swelling, and even a series of diseases such as mucosal or submucosal hemorrhage and edema are called Sinus pressure injury. Occur in the frontal sinus and maxillary sinus.

Negative pressure in the tympanic cavity can cause vasodilatation of the submucosal tissue, causing leakage of serum, or even bleeding, forming middle ear effusion or blood accumulation. The tympanic membrane itself may increase with the negative pressure of the middle ear, and may cause invagination, congestion, mucosal layer and The fibrous layer is peeled off and even perforated. Therefore, the performance of sudden feelings of ear nausea, tinnitus, headache, dizziness and other symptoms. The lighter ones only feel the ear suffocation and healed after a few hours. In severe cases, earache, tinnitus and suction loss are obvious, and it can be restored in the future. If the tympanic effusion and blood accumulation are not easy to absorb, it will last for several days. In some cases, the tympanic membrane can be congested, and the tympanic membrane can be perforated. After repeated injuries, the tympanic membrane is often invaginated, the turbidity is thickened, the activity is poor, and the vocal tract is transmitted.

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