Ver el código de «Otic barotrauma»

==Background==
*Also known as "ear squeeze" - generally seen during scuba diving or air travel

{{Barotrauma types}}
{{Diving Physiology}}

==Clinical Features==
[[File:PerforationTympan.jpg|thumb|[[Perforated TM]]]]
====Middle Ear====
*Results from inability to equalize middle ear pressure
*[[earache|Pain]], fullness, [[vertigo]], conductive [[hearing loss]], [[TM rupture]]

====Inner Ear====
*Results from forceful valsalva against an occluded eustachian tube, or rapid descent in diving or aviation
**Pressure difference between middle ear and inner ear can rupture oval or round window
*Sudden onset of sensorineural [[hearing loss]], [[tinnitus]], severe [[vertigo]]
*Must be lacking in any other neurologic signs (otherwise consider infarction)

==Differential Diagnosis==
{{Scuba diving DDX}}

{{Ear DDX}}

{{Barotrauma types}}

==Evaluation==
*Generally clinical
*Webber and Rinne for middle ear barotrauma
**Conductive hearing loss expected
*TEED grading system for middle ear barotrauma
{| class="wikitable"
|-
! Grade !! Description
|-
| 0|| Symptoms without otologic findings
|-
| 1|| Erythema and mild retraction of the tympanic membrane
|-
| 2|| Erythema of the tympanic membrane with mild or spotty hemorrhage within the membrane
|-
| 3|| Gross hemorrhage throughout the tympanic membrane
|-
| 4|| Grade 3 changes pluse hemorrhage within the middle ear (hemotympanum) 
|-
| 5|| Free blood in the middle ear plus perforation of the tympanic membrane
|}

==Management==
====Middle Ear====
*Decongestants and topical nasal vasoconstrictors
*Consider [[antibiotics]] if [[tympanic membrane rupture]]
**Remember to use medications such as [[ofloxacin]] suspension that will be safe in the middle ear
*Urgent audiology required if sensorineural hearing loss, rather than conductive hearing loss

====Inner Ear====
*Elevate head of bed
*Advise patient to not blow nose
*Antivertigo medications (e.g. [[meclizine]])
*ENT consult

==Disposition==
*Generally may be discharged with ENT follow up
*Resolution usually in 5-7 days, but can take up to 2 weeks

==See Also==
*[[Ruptured tympanic membrane]]

==External Links==

==References==
<references/>

[[Category:Environmental]]
[[Category:ENT]]