Department of Otolaryngology / Head and Neck Surgery
Barotitis occurs after flying or other activity which causes rapid changes in middle ear pressure. If the Eustachian tube cannot equalize pressure quickly enough, injury can occur. The most common scenario is during the descent of an airplane. Mild to severe discomfort may occur and blood vessels may rupture leading to bleeding behind the eardrum. This is followed by muffled hearing, a feeling of stuffiness, and continued discomfort.
The eardrum may appear bluish or red. The treatment usually consists of decongesting the nose and ears and waiting for nature to clear the fluid in the ear space. If this is a recurring problem for someone who flies a lot, ventilating tubes may be placed to prevent it. Some report success with a special earplug used during flying. If the person is a SCUBA diver, pre-dive treatment with an Afrin-like nasal spray and meticulous equalization techniques will usually prevent problems. You should never dive with tubes in the ears.