Barotitis Media

WHAT YOU SHOULD KNOW:

• Barotitis media, also known as ear squeeze, is an injury to the middle ear (area behind your eardrum). This occurs when the eustachian tube becomes blocked. This tube connects your middle ear to the back of your nose and throat. Trapped air that cannot move in and out builds up inside the middle ear. When this happens, the blood vessels and tissue that line the inside of your middle ear swell up. Barotitis media can occur when you scuba dive or travel in an aircraft. It can happen to one or both of your ears. Signs and symptoms include ear pain, ear pressure, dizziness, ringing in your ear, and trouble hearing.
  
  
• Caregivers may ask you about your recent activities, such as air travel. They may do hearing tests and look inside your ears. If you scuba dive, you will need to stop diving until caregivers tell you that it is okay to dive. Barotitis media may go away on its own, or you may need treatment for it. Caregivers may give you medicine, and surgery may be done in rare cases. Signs and symptoms of barotitis media may take up to one month to go away. You are more likely to get barotitis media again if you have had it once.

INSTRUCTIONS:

Medicines:

• Keep a written list of the medicines you take, the amounts, and when and why you take them. Bring the list of your medicines or the pill bottles when you see your caregivers. Learn why you take each medicine. Ask your caregiver for information about your medicine. Do not use any medicines, over-the-counter drugs, vitamins, herbs, or food supplements without first talking to caregivers.
  
  
• Always take your medicine as directed by caregivers. Call your caregiver if you think your medicines are not helping or if you feel you are having side effects. Do not quit taking your medicines until you discuss it with your caregiver. If you are taking medicine that makes you drowsy, do not drive or use heavy equipment.

• Analgesics: These are medicines that may help decrease your ear pain. Some analgesics may also be used to decrease swelling and fever (high body temperature).
  
  
• Antibiotics: These are medicines that kill germs and treat infection. Your caregiver may give this to you if you have a torn eardrum.
  
  
• Decongestants: These medicines help dry up extra fluid in your nose. If you have a cold or sinus infection, do not use this medicine to decrease your symptoms so that you can dive.
  
  
• Steroids: These are medicines that decrease swelling in the lining of your nose. This medicine is used by spraying it into your nose, and slowly sniffing.

Ask your caregiver when to return for a follow-up visit. Keep all appointments. Write down any questions you may have. This way you will remember to ask these questions during your next visit.

• If you scuba dive or have air travel plans, ask your caregiver when and if you can do these activities.
  
  

Valsalva's and Frenzel's maneuvers: The Valsalva's maneuver is an action that you can try, which may help your ears open up (clear your ears). Move your head forward and bend your neck slightly, so that your chin is tilted slightly down. Turn your head way from the ear that feels plugged or is painful. Pinch your nose and close your mouth. Gently push air out as if you are blowing your nose. This may cause your ears to clear. If your ear does not feel like it is clear, or you feel pain, stop trying this maneuver. The Frenzel's maneuver is another action that you can try, which may help clear your ears. This action is done by pinching your nose closed, and saying "k" over and over again.

Decreasing your risk of getting barotitis media:

• When you are traveling by air:
  
  
  • Avoid air travel if you have an upper respiratory infection (cold), or an ear infection.
    
    
  • Avoid sleeping when the plane takes off or lands.
    
    
  • Swallow, yawn, move your jaw sideways, chew gum, and sip fluids while flying on an airplane. Do these actions three to four times as the plane takes off and lands.
    
    
  • Try the Valsalva's maneuver to clear your ears as the airplane is landing if swallowing, yawning and moving your jaw has not worked. The Frenzel's maneuver may also be tried as a plane takes off or lands.
    
    
  • Follow guidelines that tell you how long to wait to fly on an aircraft after scuba diving. Scuba divers should always follow the guidelines given on dive tables and dive computers.
    
    
  • Wait to fly on a plane until 24 hours (one day) has passed after skydiving.
    
    
  • Ask caregivers about a device that may help you clear your ears while flying in an airplane. The device is put into one nostril, and the other nostril is closed by pressing on it. You blow air through the nostril with the device in it to fill a balloon.
  
  
• When you are scuba diving:
  
  
  • See your caregiver before you scuba dive. He may see if you are able to clear your ears easily. If you are not able to clear your ears, caregivers may suggest that you avoid scuba diving.
    
    
  • Do not scuba dive for two weeks after the signs and symptoms of a cold or infection have gone away.
    
    
  • Learn how to swallow, yawn, and move your jaw sideways while scuba diving.
    
    
  • Do the Valsalva's maneuver three times at every meter for the first five meters as you descend. If you feel that your ears are plugged or painful, slowly ascend. Repeat the Valsalva's maneuver as you slowly descend. If this action does not clear your ears, stop doing it.

CONTACT A CAREGIVER IF:

• You have a fever and feel dizzy after diving.
  
  
• You have new ringing in your ear after diving or traveling in an aircraft.
  
  
• Your ear feels plugged and painful after diving or traveling in an aircraft.

SEEK CARE IMMEDIATELY IF:

• Your dizziness or ear pain gets worse.
  
  
• Fluid or blood comes out from your ear or nose after scuba diving.
  
  
• You have sudden trouble hearing or you cannot hear anything after skydiving, scuba diving, or flying in an aircraft.

Copyright © 2008 Thomson Healthcare Inc. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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