A paradigm approach toward predicting barotrauma

Barotrauma is one of the most common medical problems associated with aviation and has been a causal factor for significant loss of trained aircrew hours. The occurrence of barotrauma has been reported not only in flight but also during simulated exposures to changing pressures as a part of aeromedical evaluation and training. This occurrence is despite the screening of individuals by otoscopy and tympanometry before exposure to barometric changes. In such cases, baro-challenge-induced eustachian tube (ET) dysfunction has been identified as the most probable cause, leading to decreased ability to equalize pressures across the middle ear. This paper describes a paradigm approach to the prediction of baro-challenge-induced ET dysfunction using the nine-step test and ET dysfunction questionnaire. The inclusion of the test as a screening tool before exposure of aircrew to baro-challenge after recovery from their ear, nose, and throat ailments is recommended to prevent occurrence/ reoccurrence of barotrauma.