Rupture of the Tympanic Membrane Followed by Sudden Death

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Abstract
The intrinsic strength of the tympanic membrane of a guinea pig was tested by applying static overpressure to the sealed external auditory canal. In nine ears with surgically established middle ear ventilation the mean bursting pressure was 200 mm Hg. In nine ears with a nonventilated middle ear space the mean bursting pressure was 251 mm Hg. Pressures of 400 to 475 mm Hg into a nonventilated middle ear forced air into the cranial vault from the middle ear and caused fatal arrythmias or respiratory arrest within six seconds in all cases. Similar results might be anticipated in patients with insufflation of the middle ear as well as in divers, and may be a cause of otogenic death in drowning. The risk to pilots in an aerospace environment is minimal.