title: Middle ear pressure and symptoms after skydiving.
abstract: OBJECTIVE
  Altitude-related otic barotrauma and its symptoms have been identified from air-travel, scuba diving, and hyperbaric chambers, but not in skydiving. It is not known whether skydiving-related otic barotrauma could cause symptoms severe enough for medical attention or be implicated in skydiving-related accidents. This study assessed the effect of altitude change on middle ear pressures in skydivers by comparing changes in pressure before and after a skydive, pressure changes in those who developed middle ear symptoms vs. those who did not, and pressures in those who attempted equalization vs. not.
  
  
  METHODS
  This prospective observational cohort enrolled skydivers on random days in Deland, FL. A tympanometer was used to measure middle ear pressures in decapascals (daPa) on the ground before and after skydiving.
  
  
  RESULTS
  Average middle ear pressures in 69 subjects were significantly different before (-23.5 daPa) and after (-70.5 daPa) the skydive. There were 13 subjects (18.8%) who had middle ear symptoms after descent, but there were no statistically significant differences in ear pressure changes in those with (-57.5 daPa) and without (-44.2 daPa) symptoms after their jump. There was, however, a significant difference in pressure in those jumpers who did (-32.7 daPa) and did not (-75.7 daPa) equalize successfully after their jump.
  
  
  CONCLUSIONS
  Rapid skydiving descent from high altitudes causes negative middle ear pressure changes. The ability to equalize ear pressures after a jump had a large impact on the change in ear pressure. However, the change in middle ear pressure was not associated with the presence of middle ear symptoms.
authors.affiliation: Department of Emergency Medicine Orlando Regional Healthcare, Orlando, FL 32806, USA. scott.gutovitz@orhs.org
authors.forename: Scott
authors.initials: S
authors.lastname: Gutovitz
authors.forename: Kurt
authors.initials: K
authors.lastname: Weber
authors.forename: Stacey
authors.initials: S
authors.lastname: Kaciuban
authors.forename: Robert
authors.initials: R
authors.lastname: Colern
authors.forename: Linda
authors.initials: L
authors.lastname: Papa
authors.forename: Philip
authors.initials: P
authors.lastname: Giordano
mesh_terms: D000158:Acoustic Impedance Tests; D000328:Adult; D000531:Altitude; D001265:Athletic Injuries / Q000209:etiology / Q000503:physiopathology; D001469:Barotrauma / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D004432:Ear, Middle / Q000293:injuries* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D013177:Sports / Q000502:physiology*