Otitic barotrauma results from failure to equalize pressure changes across gas-filled ear spaces, most commonly due to Eustachian tube dysfunction. It is highly prevalent among divers and aircrew, with middle ear barotrauma being the most frequent presentation. Symptoms include otalgia, hearing loss, tinnitus, fullness, vertigo, and tympanic membrane injury....
Clinicians evaluating patients with Eustachian tube dysfunction who fly, dive, or experience pressure changes should review current risk-stratification guidance outlined in this review, particularly for at-risk populations.
Otitic barotrauma is a common but underrecognized clinical problem, and a dedicated review addressing at-risk populations provides a useful synthesis for practitioners counseling patients on pressure-related ear injury prevention.
- 01Reviews the pathophysiology of otitic barotrauma (ear injury from pressure change) due to Eustachian tube dysfunction.
- 02Highlights special considerations for at-risk groups (e.g., divers, frequent flyers, pediatric patients).
- 03Published in Otolaryngologic Clinics of North America (2026).
- 04Narrative review — synthesizes existing literature rather than generating new primary data.
- 05Clinically relevant for audiologists and ENTs counseling patients before travel or pressure-altering activities.
Eustachian tube dysfunction is a primary cause of otitic barotrauma in at-risk populations.
opinionpartially supported- PMID
- 42457460
- DOI
- 10.1016/j.otc.2026.02.003.
- Journal
- Otolaryngologic Clinics of North America
- Publication type
- review
- Evidence level
- 5
- Population
- Patients with Eustachian tube dysfunction, particularly those at risk for pressure-related ear injury
- Intervention
- Review of otitic barotrauma management and risk stratification
Primary outcomes
Clinical guidance on barotrauma prevention and management; Identification of at-risk populations