American Medical Association Family Medical Guide - American Medical Association [719]
Symptoms
The symptoms of barotrauma can include moderate to severe pain in the ear, a plugged feeling in the ears, and hearing loss. You may also hear noises in the ear (tinnitus; see previous page) and feel dizzy. If the eardrum was stretched during an airplane trip, the pain usually stops when the plane lands, although the pain may persist even after the pressure inside and outside the ear is the same. Other symptoms, such as hearing loss, usually clear up within 3 to 5 hours.
Rarely, a severe imbalance in pressure can cause the eardrum to rupture (see next page), immediately relieving the pain and pressure. (You may notice a few drops of blood in your ear.) In most cases, the ruptured eardrum heals on its own. Barotrauma may also cause bleeding into the middle ear, which a doctor can see only with a lighted viewing instrument called an otoscope. The blood will reduce hearing for a few days until it is reabsorbed.
Ear examination
Doctors examine the ears with a lighted viewing instrument called an otoscope. Through the otoscope, a doctor can see many structures of the ear, including the ear canal and the eardrum.
Diagnosis and Treatment
To diagnose barotrauma, your doctor will take a detailed health history. He or she may examine the affected ear with an otoscope to look for blood in the middle ear. If you have a nose, sinus, or throat infection, your doctor may prescribe antibiotics. Your doctor will check the affected ear periodically.
Prevention
If you have a nose, sinus, or throat infection and you must fly, use a decongestant spray or oral medication before takeoff. Suck candy or chew gum, especially during the last 30 minutes of the flight, which will encourage frequent swallowing and help keep the eustachian tube open. You might also try forcing air up your eustachian tube by breathing in, holding your nose, and then trying to blow the air out while keeping your mouth closed.
Ruptured or Perforated Eardrum
The middle ear is separated from the ear canal by a thin membrane called the eardrum. The eardrum turns sound waves into vibrations that are passed along to the tiny bones of the middle ear. The eardrum can be perforated by a sharp object inserted into the ear (usually to relieve itching) or ruptured from a severe middle ear infection or a blow or other injury to the ear.
Symptoms
The symptoms of a ruptured eardrum can include pain in the ear, partial loss of hearing, or a slight discharge or bleeding from the ear. Other than the hearing loss, the symptoms usually last only a few hours.
Diagnosis and Treatment
If you have symptoms of a ruptured eardrum, cover the affected ear with a heating pad set on low, take an over-the-counter pain reliever, and see your doctor.
To diagnose a ruptured eardrum, a doctor will examine the affected ear with a lighted viewing instrument called an otoscope. If you have a ruptured eardrum, the doctor may place a temporary patch of paper over the eardrum to allow it to heal and to prevent bacteria from entering the middle ear. He or she may close a small perforation in a minor surgical procedure performed in the office. To treat or prevent an infection in the middle ear, the doctor may prescribe an antibiotic. He or she may periodically check the ear until it heals, which usually takes about 1 to 4 weeks.
After a ruptured eardrum has healed, hearing usually returns to normal. However, if the eardrum has not healed within 3 months, your doctor may recommend a procedure called tympanoplasty, in which a tiny piece of tissue is used to replace or repair the injured area of the eardrum. If any of the tiny bones of the ear are damaged, they can be repaired