barotraume

Barotrauma, or barotraume in some languages, is tissue injury caused by pressure differences between the external environment and gas-filled spaces within the body. It occurs when ambient pressure changes are rapid or extreme and the body's natural mechanisms for equalizing pressure cannot compensate, leading to rupture or damage of affected structures.

The condition most often affects air-containing spaces such as the middle ear, sinuses, and lungs. In settings like flying or diving, rapid ascent, descent, or inadequate equalization can trap air and cause injury. Ear barotrauma (barotitis media) results from poor Eustachian tube drainage and presents with ear pain, fullness, hearing loss, tinnitus, or vertigo. Sinus barotrauma causes facial pressure and nosebleeds. Pulmonary barotrauma arises from alveolar overexpansion, potentially leading to pneumothorax, pneumomediastinum, or subcutaneous emphysema, and may occur during deep-sea diving or mechanical ventilation.

Diagnosis is clinical, based on history and examination, with imaging (such as chest X-ray or CT) used when complications are suspected. Treatment focuses on relieving pressure and preventing further injury: allowing time for natural pressure equalization, analgesics and decongestants for mild cases, and avoidance of further pressure changes. Persistent tympanic injury or ruptured membranes may require ENT evaluation. Pulmonary barotrauma with pneumothorax or pneumomediastinum requires appropriate management, including relief of the air leak and, if necessary, thoracic interventions.

Prevention centers on avoiding rapid pressure changes when possible and ensuring proper equalization techniques. Divers should ascend slowly with safety stops and avoid diving with congested sinuses or upper respiratory infections; travelers should use nasal decongestants with caution if advised by a clinician. Risk groups include divers, pilots, and patients on mechanical ventilation.