Barotrauma is the pain or discomfort that you feel when there is a difference in air pressure between the outside environment and the inside of your body. You may have this discomfort when you fly in an airplane or go scuba diving.

The air inside your body squeezes together or swells as the outside pressure increases or decreases. The outside pressure can increase or decrease from water or air pressure. The squeezing and the swelling can cause pain and damage. Barotrauma can affect the ear, face (sinuses), and lungs. It can affect any part of the body with air inside.

The Ear
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Ear Barotrauma
  • Barotrauma most commonly affects the middle ear. The middle ear has a pocket of air that is sensitive to changes in air pressure.
    • You have a thin layer of skin (or membrane) at the end of the ear canal. It vibrates and sends sound to your middle ear. This is called the eardrum.
    • The air pressure inside and outside your ear is normally same. The eustachian tube connects the middle ear and the throat. It works to balance the air pressure on both sides of your eardrum. It allows air to flow into or out of the middle ear.
    • Ear barotrauma happens when the eustachian tube gets blocked. Your body cannot balance the air pressure inside and outside the eardrum.
    • Ear barotrauma is usually not severe or dangerous. It is easily treatable. Sometimes there are complications such as loss of hearing, ear infection, dizziness, or a perforated (punctured) eardrum.
Sinus Barotrauma
  • Sinuses are air-filled pockets in the bone around the nose.
    • Sinus barotrauma occurs when there is a difference in pressure between the air in the sinuses and the pressure outside.
    • You may experience pain around your cheek bones or above your eyes.
    • You may also experience headaches.
    • It may lead to severe sinus infection if you also have a cold or nasal congestion.
Pulmonary (Lung) Barotrauma

Pulmonary barotrauma is the injury that is caused when outside pressure is different than the pressure of the air in your lungs.

  • Scuba divers swim with canisters of compressed air. It allows them to breathe under water. The lungs may overinflate if a diver has too much compressed air and returns to the surface of the water without properly exhaling. One complication is that the lung could collapse.
  • Another complication is decompression sickness. This is also referred to as "the bends."
    • Nitrogen is a chemical dissolved in blood by high pressure. It forms bubbles as pressure decreases (such as when you swim up to the surface when diving). These bubbles may leak out into your bloodstream as air bubbles called air embolisms.
    • Air embolisms can travel to any organ in the body. They are dangerous when they block blood vessels that feed an organ such as the heart, lungs, and the brain.
    • Decompression sickness is classified as Type 1 or Type 2. Type 1 is when the bubbles affect the tissues around joints. Knees, elbows, and shoulders are most often affected. Type 2 is more serious. It involves the central nervous system (brain and spinal cord) or the lung and heart.

Barotrauma can even be due to equipment such as a mask or dry suit used for scuba diving. The equipment can block and trap air against the skin. You may become injured if an air pocket happens when you dive. Dry suits can painfully pinch your skin. Masks can cause blood vessels in the eyes to burst.

Contact your doctor if you think you may have some type of barotrauma.

Barotrauma is caused when the air pressure inside and outside the body are different. This results in discomfort. Causes include:

  • Flying
  • Scuba diving
    • Ascending (going up to the surface) without exhaling freely
    • Swimming quickly to the surface when diving
    • Holding your breath when ascending
    • Underwater diving for an increased period of time
    • Repeated dives within 24 hours
    • Flying in an airplane after diving
    • Having air pockets in equipment (such as masks and dry suits)