<prompt> Barotraumatic otitis media is a result of:Rapid descent while in an aircraftRapid ascent while in an aircraftSudden acceleration while in a busSudden deceleration while in a bus  <response>: Ans: A Rapid descent while in an aircraft Ref: Diseases of the Ear Nose and Throat by PL Dhingra.5th edn .2010.pg 74Explanation:Barotraumatic otitis mediaSeen in rapid descent during flight, deep water divingMechanism: when the difference between the atmospheric pressure and the middle ear pressure is 90mmHg then there occurs locking of the Eustachian tube.Locking occurs because collapse of soft tissue into the Eustachian tube.The negative middle ear pressure leads to transudation, hemorrhage and even ruptures of tympanic membrane and round window.Patients will complain of ear fullness, decreased hearing, earache and tinnitusOE tympanic membrane may retracted, congested or even ruptured, hubbies may be seen in the middle ear through the tympanic membrane.Treatment: Nasal decongestants and anti-histaminics and in severe cases a myringotomy may be required. 