title: Point prevalence of barotitis and its prevention and treatment with nasal balloon inflation: a prospective, controlled study.
abstract: BACKGROUND
  The most common cause of barotitis is pressure changes induced during descent in aviation. The incidence after air flight has been reported to vary from 8% to 17%.
  
  
  OBJECTIVE
  We conducted this study to estimate the incidence of barotitis after flight, to evaluate whether the incidence of barotitis can be reduced by nasal balloon inflation during descent, and, finally, to estimate the effect of nasal balloon inflation in case of negative middle ear pressure after landing.
  
  
  METHODS
  Aircraft passengers were examined by otoscopy and tympanometry before and after flying and filled in a questionnaire inquiring about ear problems. On half of the flights, the passengers were asked to inflate a nasal balloon during descent, whereas the other half were control flights.
  
  
  RESULTS
  A total of 188 passengers filled in the questionnaire. Of these, 134 were examined before and after the flight. Otoscopic signs of barotitis were found in 15% of the ears in the control group compared with 6% in the balloon inflation group. In ears with a negative pressure after flying, the pressure could be equalized by Valsalva's maneuver in 46%. Passengers who were unable to equalize the pressure in this way inflated a nasal balloon, and in 69%, this maneuver cleared the middle ear pressure.
  
  
  CONCLUSIONS
  The incidence of barotitis in this study of aircraft passengers was 14%. This figure could be reduced to 6% in passengers who performed nasal balloon inflation during descent. We recommend nasal balloon autoinflation in aircraft passengers who have difficulty clearing their ears during and after flying.
authors.affiliation: ENT Department, Gentofte University Hospital, Copenhagen, Denmark. stangerup@pc.dk
authors.forename: Sven-Eric
authors.initials: SE
authors.lastname: Stangerup
authors.forename: Mads
authors.initials: M
authors.lastname: Klokker
authors.forename: Søren
authors.initials: S
authors.lastname: Vesterhauge
authors.forename: Samuel
authors.initials: S
authors.lastname: Jayaraj
authors.forename: Peter
authors.initials: P
authors.lastname: Rea
authors.forename: Jonathan
authors.initials: J
authors.lastname: Harcourt
mesh_terms: D000158:Acoustic Impedance Tests / Q000379:methods; D000293:Adolescent; D000328:Adult; D001469:Barotrauma / Q000453:epidemiology* / Q000517:prevention & control*; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D015994:Incidence; D008131:London / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D038781:Otoscopy / Q000379:methods; D011312:Pressure; D015995:Prevalence; D011446:Prospective Studies; D012648:Self Care / Q000295:instrumentation*; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D014636:Valsalva Maneuver