HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Free Full Text (PDF) Free All Versions of this Article: 98/5/1592    most recent 00974.2004v1 Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via ISI Web of Science (3) Citing Articles via Google Scholar Google Scholar Articles by Kanick, S. C. Articles by Doyle, W. J. Search for Related Content PubMed PubMed Citation Articles by Kanick, S. C. Articles by Doyle, W. J.

Barotrauma during air travel: predictions of a mathematical model

¹Department of Pediatric Otolaryngology, Children's Hospital of Pittsburgh, ²Department of Chemical and Petroleum Engineering, University of Pittsburgh, and ³Department of Otolaryngology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania

Submitted 7 September 2004 ; accepted in final form 14 December 2004

Middle ear barotrauma during flight is a painful disorder experienced by passengers who cannot properly regulate their middle ear pressure in response to the changing cabin pressures during ascent and descent. Previous reports emphasized the important role of poor eustachian tube function in disease pathogenesis but paid little attention to other moderating factors. Here we describe a mathematical model of middle ear pressure regulation and simulate the pressure response to the changes in cabin pressure experienced over typical flights. The results document buffering mechanisms that decrease the requisite efficiency of active, muscle-assisted eustachian tube opening for disease-free flight. These include the relative difference between destination and departure elevations and the ratio of maximum tympanic membrane volume displacement to middle ear volume, where greater absolute values require lesser efficiencies for disease-free flight. Also, the specific type of functional deficit is important since ears with a completely obstructed eustachian tube can be less susceptible to barotrauma than those with a eustachian tube that passively opens but fails to dilate in response to muscle activity. These buffering systems can explain why some children and adults with poor eustachian tube function do not experience middle ear barotrauma.

middle ear pressure regulation; eustachian tube; Valsalva maneuver; tympanic membrane