Which practice helps prevent barotrauma during ascent and descent?

• A. Descend rapidly to relieve pressure
• B. Perform the Valsalva maneuver or swallow or yawn to equalize middle ear pressure
• C. Hold breath during rapid changes
• D. Increase cabin altitude

Answer: (B)

During ascent and descent, cabin pressure changes faster than the air in the middle ear can automatically equalize. The middle ear connects to the throat via the Eustachian tube, and when you swallow, yawn, or chew, this tube opens to let air flow and balance the pressure on both sides of the eardrum. The Valsalva maneuver—gentle nose-closing and exhaling with a closed mouth—also pushes air through the Eustachian tube to achieve this balance. Keeping the middle ear pressure equal to the ambient pressure prevents painful pressure differences and potential injury to the eardrum and middle ear structures. Rapid descent, holding your breath, or increasing cabin altitude would worsen or trap pressure differences, so they’re not helpful. Using these gentle equalization techniques as you ascend or descend safely minimizes barotrauma risk.