Barotrauma.......very very simplified.
The function of hearing is best served when the pressure in the middle ear is the same as the pressure in the outer ear...............equal pressure on both sides of the eardrum.
In barotrauma ( for whatever reason) a state occurs when the pressure in the middle ear becomes negative to the pressure in the outer ear and the ear drum tends to be "sucked in"
Now the outer ear and ear drum is made of strong stuff, being covered by skin and the effect of barotrauma to that part of the ear is "no big deal"
HOWEVER,,,,the lining of the middle ear is of more delicate stuff and is vulnerable to the effects of negative pressure.
SO...the deleterious affects of barotrauma (if any) is entirely focused on the middle ear.