The most common situation is airline travel in a person with inflammation, but scuba diving can also produce significant barotrauma. Patients complain of ear pain and loss of hearing. Uncompensated air pressure changes cause distortion and increased vascularization of the tympanic membrane followed by edema of the middle ear mucosa and even bleeding into the middle ear. Rapid air pressure changes may result in perforation of the tympanic membrane. Symptoms are usually relieved by analgesics and decongestants.
Perforations usually heal well without intervention.
Prevention of barotrauma is based on avoiding pressure changes if possible and taking measures to enhance eustachian tube efficiency. Use of systemic decongestants or topical nasal decongestants before airline travel can be helpful, and patients can be taught techniques to enhance eustachian tube patency. Approximately 2 percent of pregnant women receiving Medicaid use benzodiazepines. Some studies have linked benzodiazepine use during pregnancy to facial cleft and skeletal abnormalities in the fetus, but the evidence has been inconsistent and difficult to evaluate. A review of seven cohort studies did not show any association between benzodiazepine use during pregnancy and major malformation in the fetus.