To investigate the mechanism of barotrauma to the inner ear, we used electrophysiologic methods to evaluate guinea pigs exposed to such trauma, and compared the findings with those observed by scanning electron microscopy (SEM). Guinea pigs with good Preyer's reflexes were studied. In those animals that showed a loss of or decrease in Preyer's reflexes and/or nystagmus following exposure to an increase and decrease in pressures in a high-pressure chamber, we measured compound action potentials (CAPs) and cochlear microphonics (CMs) 7-11 days after the exposure. The pressure was increased from 1 ATA to 2 ATA over 30 sec and maintained for 10 min, then pressure was decreased to 1 ATA over 30 sec. Specimens obtained from animals in which CAPs and CMs could be measured were prepared for SEM examination. CAPs and CMs were measured at decreasing 5 dB increments to the visual threshold level of detection with tone bursts at 1, 2, 4 and 8 kHz. Based on the CAPs measured 7-11 days after exposure, guinea pigs were divided into two groups by CAP thresholds, those with severe damage and those with mild damage. None of the animals showed moderate damage. The group with high CAP thresholds showed severe damage to hair cells on SEM, while the group with low CAP thresholds showed no specific morphological abnormalities on SEM. It appeared that some guinea pigs with normal SEM findings following barotrauma to the inner ear did not achieve complete recovery of hearing. From these results, it was speculated that some animals had sustained reversible damage in the mild group and that these animals had recovered from moderate damage. The elevation of CMs was usually not high compared to that of CAPs in the high frequency area, and 4 animals showed CAP and CM separation above 30 dB at 8 kHz. These findings suggested that the group with severe damage exhibited multiple patterns of injury.