Abstract
Otic barotrauma is a potential risk for travelers using commercial aircraft. A significant proportion of passengers are infants. No literature exists regarding pre-flight assessment for prevention of barotrauma in infants due to air travel. Infants are preverbal in their development and cannot communicate their distress with words, though will show age-typical distress and pain responses. Pain and concomitant trauma, where possible, are ideally prevented. This paper suggests that it may be possible for parents to detect prior to flight whether their infant is likely to suffer pain from Eustachian tube malfunction with in-flight cabin pressure changes. This may be achieved by co-incidental observation of infants and their subsequent distress with small rapid air pressure change, such as in rapid elevator ascent/descent, which elicits ear popping in the parents. This may help predict a healthy infant's response to change in air pressure during air travel. A case example is given. Barotrauma in the context of the infant's neuropsychology is described and relevant literature to the topic is reviewed.
Highlights
Worldwide airlines transport over 1.25 billion passengers per year [1]
Infants may be at even greater risk of discomfort, ear pain and barotrauma
A literature review was performed in May 2013 on PubMed, Informit, Uptodate, Google Scholar and National Centre for Biotechnology Information using key words “infant, ear, barotrauma, prevention, air travel”
Summary
Worldwide airlines transport over 1.25 billion passengers per year [1]. A significant proportion of those passengers are infants. Infants for developmental reason cannot equalise ear pressure in the same way as older children and adults who for example can initiate a Valsalva maneuver. Infants may be at even greater risk of discomfort, ear pain and barotrauma. With repeated episodes of barotrauma infants may be at risk of longer lasting sequelae of physical and psychological trauma. Numerous guidelines offer advice on how to prevent barotrauma and how to address air pressure changes in flight
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