Surgical and Conservative Management in Otitic Barotrauma: A Retrospective Cohort Study.

Objective: Analyze the relationship between surgical and non-surgical interventions for otitic barotrauma (OB), and identify underlying medical diagnosis, recurrence rates, and treatment outcomes.

Study design: Retrospective cohort analysis.

Setting: TriNetX US collaborative network.

Methods: The network was queried for patients diagnosed with OB within the past 20 years and a surgical intervention within 1 month. Patients receiving surgical intervention were assigned to the surgical cohort while those that did not receive operative care were assigned to the non-surgical cohort. Cohorts were 1:1 propensity score matched for age and gender.

Results: Patients that undergo operative treatment have significantly increased association with previous diagnoses of middle ear pathology, as well as most forms of sinonasal disease (P < .05). Surgical treatment was significantly associated with recurrence of OB, tympanic membrane (TM) perforation, otitis media, as well as mixed hearing loss (P < .05).

Conclusion: Our study indicates an association between previous sinonasal and otologic pathology and higher likelihood of undergoing operative treatment for OB. Our findings also indicate that operative treatment is significantly associated with recurrence of the condition. Increasing air travel and participation in recreational activities tied to OB underscore the need to better understand treatment options.