![]() ![]() Pain can be severe, sometimes accompanied by facial tenderness on palpation. Divers experience mild pressure to severe pain, with a feeling of congestion in the involved sinus compartments during ascent or descent and sometimes epistaxis. ![]() It can affect the ear (causing ear pain, hearing loss, and/or vestibular symptoms) or the sinuses. Sinus barotrauma most often affects the frontal sinuses, followed by the ethmoid and maxillary sinuses ( 3 General references Barotrauma is tissue injury caused by a pressure-related change in body compartment gas volume. Weakness of both upper and lower face distinguishes facial baroparesis from stroke or arterial gas embolism ( 1 General references Barotrauma is tissue injury caused by a pressure-related change in body compartment gas volume. When pressure within the middle ear remains elevated during or after ascent from a dive, the facial nerve can be compressed (facial baroparesis), resulting in ipsilateral upper and lower facial paresis. On examination of the ear canal, the tympanic membrane may show congestion, hemotympanum, perforation, or lack of mobility during air insufflation with a pneumatic otoscope conductive hearing loss is usually present. Inflow of cold water to the middle ear may result in vertigo, nausea, and disorientation while submerged. Typically, divers experience ear fullness and pain during descent if pressure is not quickly equilibrated, middle ear hemorrhage or tympanic membrane rupture may occur. Diving can affect the external, middle, and inner ear. ![]()
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