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Understanding Ear Barotrauma in Scuba Diving: Symptoms, Care, and Prevention

Updated: Sep 8, 2023

An illustration of the human ear inner part


Scuba diving is a thrilling and adventurous sport that allows us to explore the captivating underwater world. However, with this excitement comes the need for caution, as divers may encounter various challenges, including ear barotrauma. This condition can result from pressure changes during dives and may lead to discomfort and potential complications. In this blog post, we will delve into ear barotrauma, exploring its causes, symptoms, care, and essential prevention techniques to ensure a safe and enjoyable diving experience.

Overview of Ear Barotrauma:

Ear barotrauma, also known as "aero-otitis" or "barotitis media," is a diving-related injury that arises due to unequal pressure in the middle ear. During a dive, as you descend into the depths of the water, the pressure increases significantly. Similarly, as you ascend back to the surface, the pressure decreases. The middle ear, being an air-filled cavity, is sensitive to these pressure changes, and when it fails to equalize with the surrounding water pressure, ear barotrauma can occur.

Symptoms of Ear Barotrauma:

1. Ear Pain: One of the most common and noticeable symptoms of ear barotrauma is sharp or throbbing pain in one or both ears. This discomfort can range from mild to severe and may be exacerbated during ascents.

2. Muffled or Decreased Hearing: Divers with ear barotrauma often experience a sensation of muffled or reduced hearing. This occurs due to the pressure affecting the movement of the eardrum, resulting in diminished sound transmission.

3. Dizziness and Vertigo: Pressure imbalances in the middle ear can trigger feelings of dizziness or vertigo, leading to a sense of unsteadiness and disorientation.

4. Bleeding or Fluid Drainage: In more severe cases, ear barotrauma may cause bleeding from the ear canal or drainage of fluid. This indicates potential damage to the eardrum or nearby structures.

Care for Ear Barotrauma:

If you suspect you have developed ear barotrauma during a dive or shortly after, it's crucial to take appropriate care to promote healing and prevent further complications:

1. Ascend Slowly: If you experience symptoms of ear barotrauma while diving, it's essential to ascend slowly and in a controlled manner. Rapid ascents can worsen the condition and lead to additional injuries.

2. Equalize Regularly: Equalization is the key to preventing ear barotrauma. Make a conscious effort to equalize the pressure in your ears frequently as you descend. The Valsalva maneuver, where you gently blow through your nose while pinching your nostrils shut, is a common and effective equalizing technique.

3. Stop Diving: If you experience severe pain or any of the symptoms mentioned earlier, stop diving immediately. Continuing to dive with ear barotrauma can lead to further damage and complications.

4. Seek Medical Attention: If symptoms persist or worsen after diving, seek medical evaluation from a healthcare professional experienced in diving-related injuries. They can provide appropriate care and advice for a speedy recovery.

Prevention Techniques for Ear Barotrauma:

Preventing ear barotrauma is essential for a safe and enjoyable scuba diving experience. Incorporate the following techniques into your diving routine to reduce the risk of ear injuries:

1. Proper Equalization Techniques (watch the video): Master the various equalization techniques and practice them regularly before and during dives. Besides the Valsalva maneuver, other methods like the Toynbee maneuver (swallowing with the nose and mouth closed) and the Lowry technique (moving the jaw forward) can be effective for some divers.

2. Stay Healthy Before Diving: Avoid diving if you have a cold, allergies, or sinus congestion, as these conditions can hinder the proper functioning of the Eustachian tube and make equalization challenging.

3. Descend and Ascend Slowly: Take your time during descents and ascents to allow your ears to adjust gradually to the changing pressure. Rushing can cause undue stress on your middle ear and increase the risk of barotrauma.

4. Communication and Buddy System: Always dive with a buddy and communicate any discomfort or issues during the dive. Your dive buddy can assist you if you encounter difficulties and ensure your safety.

5. Regular Diving Training: Undertake regular diving training and refreshers to maintain proper techniques and safety protocols. Proper training can equip you with the knowledge to handle various situations, including potential ear barotrauma.


Ear barotrauma is a common concern for scuba divers, but with proper knowledge, care, and preventive measures, it can be minimized or avoided altogether. Understanding the condition, recognizing its symptoms, and knowing how to equalize properly during dives are essential aspects of safe diving practices. Prioritizing your health, seeking medical attention when necessary, and maintaining open communication with your dive buddies are all crucial components of an enjoyable and safe diving experience. Embrace the beauty of the underwater world responsibly, and let the wonders of scuba diving continue to captivate and inspire you. Happy diving!

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