Efficacy of Pseudoephedrine and Oxymetazoline in Preventing Otic Barotrauma: A Systematic Review and Meta-Analysis

In adults, oral pseudoephedrine demonstrated a consistent and clinically meaningful reduction in otic barotrauma in older RCTs; intranasal oxymetazoline showed only modest and variable benefit. The evidence base is dated (1992 to 1998) and limited in size-contemporary, adequately powered RCTs with standardized outcome measures are needed. Clinicians may prefer pseudoephedrine for short-term prophylaxis in adults without contraindications, alongside non-pharmacologic measures.