This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Disorders of Middle Ear (Otitis Media), Subject name: ENT
Barotraumatic otitis media is a result of: 
Select and explain. 
A. Rapid descent while in an aircraft, B. Rapid ascent while in an aircraft, C. Sudden acceleration while in a bus, D. Sudden deceleration while in a bus
A: Rapid descent while in an aircraft
Answer: A: Rapid descent while in an aircraft 
Explanation: 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 tinnitusO/E 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.