Barotrauma In Children: Signs And Treatment

Introduction

Barotrauma is caused by sudden shifts in the air or water pressure in the body. Usually, this condition is not serious and can heal on its own; however, sometimes, it can be very serious and require medical interventions. Barotrauma is a condition that can happen when the pressure around us changes too quickly, like when we're scuba diving, flying, mountain climbing, or skiing. This happens because of Boyle's Law, which says that if the temperature of a gas stays the same, the pressure and volume of the gas are related. For example, when we dive underwater, the pressure gets higher, and the air in our lungs gets compressed. If we don't equalize the pressure in our ears, sinuses, and teeth by breathing out, we can get hurt.¹

Explanation of barotrauma and its causes

Barotrauma occurs when the body experiences sudden changes in air and water pressure.  “Airplane ear’ is an example of barotrauma, which affects the middle ear. It can happen while flying in an aeroplane. Only in rare cases can it cause a ruptured ear drum. Sinus barotrauma is another example of barotrauma, and it can happen due to the changes in the air or water pressure in your sinuses. Sinuses are air-filled spaces in the skull, and they can be found in your forehead, cheeks, eyes, and other body parts. It is associated with and caused by scuba diving.

How barotrauma can affect children

Barotrauma is mostly common among air travellers. It can target those who fly while having allergies, colds, and infections. The reason for it being common among children is that developing Eustachian tubes are narrower than those in adults, and they can become blocked more easily.² 

Signs of barotrauma in children

Common symptoms

Common symptoms symptoms of a blocked eustachian tube include feeling like your ears are full or stuffed, muffled hearing, and ear pain. 

Signs that may indicate a more serious condition

If you hear a "pop" in your ears, it means your eustachian tubes are open. However, if they remain blocked, your middle ear can fill with clear liquid, causing more severe symptoms such as extreme ear pain, dizziness, a ruptured eardrum, or even hearing loss. In most cases, mild symptoms will go away on their own after you return to land, but if your symptoms persist or are severe, it's important to see a doctor.

Treatment of barotrauma in children

When you get barotrauma, how it's treated depends on which part of your body is hurt. If your ears are hurt, you might not need any special care to make them feel better. But if your lungs are hurt, you will almost always need some kind of treatment to help you recover. If you notice barotrauma symptoms in your child, you should consider the following:

First aid measures for barotrauma

When your child has such a medical emergency, doctors act quickly to help them. They give the person fluids, provide them with 100% oxygen to breathe, and position them on their left side with their head slightly tilted downwards. In some cases, they may also take the child to a special medical facility called a hyperbaric chamber, which can either be a standalone facility or part of a hospital.

Medications and surgical procedures

When someone has ear barotrauma, the first step in treatment is usually taking medication to open up the eustachian tube, which is a small tube that connects the middle ear to the back of the throat. Sometimes, antihistamines might be prescribed if allergies are involved. Pain medication can help relieve discomfort, and ear drops might be used if the eardrum is not ruptured. However, if the eardrum is ruptured, antibiotics may be needed to prevent an infection. If there are hearing problems or the eardrum is damaged, a hearing test may be recommended. For facial paralysis caused by barotrauma, oral steroids might be prescribed by a doctor to help the patient recover.

Rehabilitation measures for hearing loss

There are certain rehabilitation measures that can be taken for hearing loss, and it depends on the causes of the hearing loss. In the case of barotrauma, rehabilitation measures can be taken through hearing aids and cochlear implants if the child patient is eligible and even used in profound deafness cases.

It's important to consult a qualified healthcare professional to determine the best course of treatment for a child with hearing loss caused by barotrauma. Early intervention and treatment can help minimize the long-term impact of hearing loss on a child's development and quality of life.

Prevention of barotrauma in children

When your child goes diving, the pressure changes as they go deeper into the water. To make sure they stay safe, they need to make sure the pressure inside their body matches the pressure outside. They can do this by using special equipment with a steady air supply, such as from a diving helmet or tank.

If your child wears earplugs or tight-fitting goggles while diving, it can create a space where pressure can't be equalized. So, it's best to avoid wearing these things. However, if your child has a stuffy nose, they can take medicine before diving to help equalise the pressure in their ears and sinuses.

As your child comes back up to the surface, they need to breathe out any air they inhaled while they were in the water. This helps prevent lung problems. Children with lung diseases, like asthma, should get checked before diving to make sure it's safe for them to go.

If you're flying, it's a good idea to get your child special earplugs to help protect your and their ears from getting hurt by the changes in air pressure. You can also try chewing gum, blowing your nose, or yawning to help equalize the pressure in your/their ears. This can prevent any pain or damage that might happen during the flight.

When to seek medical attention

If you feel like your child's ears are still clogged or full even after a flight or scuba diving, it's important to talk to the doctor. Ear barotrauma, also known as "aeroplane ear," is usually a temporary problem, but it's still a good idea to ask your doctor some questions. You might want to know what caused it and if it's a serious issue. You might also be worried about your child losing their hearing, but your doctor can reassure you. They can also tell you about different treatments and ways to prevent it from happening again.

Summary

Barotrauma is a condition that happens when your body experiences sudden changes in pressure, like when you go diving, fly in an aeroplane, climb a mountain, or ski. It can make you feel like your ears are blocked or full or cause ear pain or hearing problems. Children are more vulnerable to barotrauma because their Eustachian tubes are narrower and can get blocked more easily. If you think your child has barotrauma, it's important to get medical help. Treatment can include medication, pain relief, and even surgery in some cases. If hearing loss occurs, rehabilitation measures like cochlear implants may be necessary. To prevent barotrauma, children should take special precautions when participating in activities that may cause it. Using special air from a diving helmet or tank and avoiding earplugs or tight-fitting goggles while diving can help. Kids with lung diseases should also receive medical clearance before diving. With proper prevention and treatment, the long-term impact of barotrauma on a child's development and quality of life can be minimized.