Otitic Barotrauma Due to Eustachian Tube Dysfunction and Special Considerations in At-Risk Populations.

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. Inner ear barotrauma is less common but potentially severe, especially after forceful equalization. Management depends on severity and includes prevention, conservative treatment, otolaryngologic assessment, and, in selected recurrent barochallenge-related cases, balloon dilation of the Eustachian tube.