Air Traveller


Barotitis – inflammation of the middle ear.

Barotitis is an acute inflammation, which occurs due to that a negative pressure builds up in the middle ear. This occurs when there is a change in surrounding atmospheric pressure, e.g. in the cabin of an aircraft, particularly when descending. The characteristics of Barotitis are pain and temporary hearing impairment in the affected ear. Occasionally there may be vertigo and a hearing impairment of a more permanent nature. With OTOVENT® , equalizing the pressure is easy.

The incidence of developing Barotitis is approximately 10% amongst adults and 20% in children. In a study published in 2004 it was established that 14% of 188 passengers experienced symptoms of Barotitis . This was reduced to 6% following inflation with OTOVENT®.



Normal pressure in the middle ear.



During ascent:
Increased pressure in the middle ear.



On landing:
Dysfunction of the Eustachian tube with negative pressure in the middle ear. The eardrum bulges inwards and hearing is
almost normal.




Following landing:
Negative pressure in the middle ear. The eardrum bulges in and hearing is impaired.

During air travel a negative pressure may develop in the middle ear. The problem arises in connection with descent when the atmospheric pressure in the cabin increases, whereby a negative pressure behind the eardrum occurs, drawing it inwards. If the negative pressure cannot be normalized this leads to an extremely painful condition, called Barotitis, which may cause vertigo (normally transient) and impaired hearing. It has been shown that children under 8 years old develop varying degrees of Barotitis during air travel.1, 2, 4 Adults are normally able to normalize the negative pressure by squeezing the nostrils together and forcing air into the ear (this method is called the Valsalva manouevre). However children, and a proportion of adults, have difficulty peforming this.

The Otovent® method.

The majority of individuals suffering pain from negative pressure in the middle ear can simply use the OTOVENT® balloon in order to equalize the negative pressure. The method is simple to perform and is also suitable for children from the age of 3 years. The OTOVENT® method can easily be treated as a game. Practise by blowing up the balloon a couple of times via each nostril using the nose adaptor before flying (see below). It is advisable to begin equalizing the pressure when descending is announced. Best results are achieved where equalization is commenced before the negative pressure in the ear is experienced.


page6rightHow to use the Otovent®?

1. Connect the balloon to the nose piece. Hold the round part of the nose piece firmly against the right nostril with the right hand. Press the left nostril closed with the left hand.

2. Inhale deeply, close the mouth and inflate the balloon until it is the size of a grapefruit by blo- wing through the nostril.

3. Repeat the procedure with the left nostril. You will know that the treatment works if the child experiences a pressure increase and/or a “click” in the ear.

If the child does not experience any change:
Repeat step 2, then incline the head slightly forward and turn the head to the right.
Repeat step 3, when the balloon is inflated, try to swallow. Observe that the nose piece should be held tightly against the nostril.

You will know that the treatment works if your child experiences a pressure increase and/or a “click” in the ear.

Note! Maximum 20 inflations per balloon.



The Otovent® method is also recommended for children with recurrent inflammation of the middle ear.

The OTOVENT® method is well proven and a first-line treatment in attempting to avoid surgical insertion of a plastic grommet in the eardrum. Documentation is available proving the effectiveness of this method in both children and adults. Read more at


1. Stangerup SE, Klokker M, Vesterhauge S, Jayaraj S, Rea P, Harcourt J, Point Prevalence of Barotitis and Its Prevention and Treatment with Nasal Balloon Inflation: A Prospective, Controlled Study. Otol Neurotol 25:89-94,2004.

2. Stangerup SE, Tjernström O, Klokker M, Harcourt J, Stokholm J. Point prevalence of barotitis in children and adults after flight, and effect of autoinflation. Aviat Space Environ Med. 1998 Jan;69(1):45-9.

3. Hanner P. Non surgical treatment of otitis media with effusion. Indian Journal of Otology Vol.3, No.3 (Sept.97), 101-107.

4. Stangerup SE, Tjernstrom O, Harcourt J, Klokker M, Stokholm J. Barotitis in children after aviation; prevalence and treatment with Otovent®. J Laryngol Otol. 1996 Jul;110(7):625-8.

5. Blanshard JD, Maw AR, Bawden R. Conservative treatment of otitis media with effusion by autoinflation of the middle ear. Clin Otolaryngol Allied Sci. 1993 Jun;18(3):188-92.

6. S. E. Stangerup, MD;J. Sederberg-Olsen, MD; V. Balle, MD. Autoinflation as a Tretmentof Secretory Otitis Media. Arch Otolaryngol head Neck Surg. 1992;118:149-152

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