This article talks about a few precautions that need to be taken to prevent ear problems when flying.
The ears and the nasopharynx are connected internally by the eustachian tube. Ears are typically aerated by the periodic opening of the eustachian tube so that the air pressure inside the middle ear is equalized with that of the atmosphere. The eustachian tube opens each time we swallow, chew, or yawn.
Any change in the atmospheric pressure, like during a flight or deep-sea diving, compromises the functions of the eustachian tube. It gets further aggravated if there is a common cold or a nasal obstruction.
Also called ear barotrauma, airplane ear occurs when stress is exerted on the eardrum due to a deviation in the ear pressure. It is otherwise called aerotitis media or barotitis media.
During an ascent or a descent of the flight, pressure changes occur in the nasopharynx because of a rapid change in altitude. The eustachian tube neutralizes the effect on the ears, which usually opens up with a click. But, in the case of a nasal allergy or an infection, dysfunction of the eustachian tube occurs due to a collapse or swelling of the tube. This causes a failure of the tube to open. It leads to a sudden onset of negative pressure inside the middle ear, which in turn causes severe pain in the ears during ascent or descent. This pain often lasts for a week to 10 days. If it persists longer, medical attention is necessary.
As the name suggests, the most common cause of airplane ear is traveling at a high altitude, especially in airplanes, helicopters, etc.
However, it can also occur due to the below-mentioned causes:
Traveling in the mountains.
Elevators ride in tall buildings.
Hyperbaric oxygen chambers.
Living in war zones, where explosions take place.
Though mountain and elevator rides might produce ear barotrauma, it is usually mild.
Airplane ears can be either unilateral or bilateral. In most cases, it is mild, while there can be a manifestation of severe symptoms in a few.
The following are the symptoms of airplane ear:
Hearing loss can range from mild to moderate.
Moderate pain or discomfort in the ears.
Stuffiness in the ears.
Tinnitus (ringing sensation in the ears).
Extreme pain in the ears.
Hearing loss in the ears can be severe.
Bleeding from the ears.
Vertigo (spinning sensation)
Ear pressure is abnormally high.
Since the eustachian tube is responsible for normalizing the ear pressure, any defects or conditions that affect the eustachian tube are the risk factors that can increase the chance of an airplane ear.
The following are the conditions that make you prone to ear barotrauma:
Allergic rhinitis or hay fever.
Small-sized eustachian tube. In general, infants and toddlers have a smaller eustachian tube compared to adults.
Otitis media (infection of the middle ear).
Individuals who do not involve themselves in activities like yawning or swallowing during the ascent or descent of an airplane. This is because when we yawn or swallow, the pressure gets equalized.
If you have a blocked nose, you need to take two to three drops of a nasal decongestant (nasal drops) in both the nasal cavities at least 5 to 10 minutes before boarding. However, overusing it can increase congestion. Decongestant tablets will also be helpful and should be taken at least half an hour to an hour before starting your trip.
Do not blow your nose, especially if there is a nasal discharge.
Keep chewing bubble gum.
You can take small sips of juice or water.
Do not sleep during ascent or descent.
Do not use earphones or earplugs during ascent and descent, especially while swallowing or chewing.
To equalize the pressure during ascent and descent, perform activities like swallowing and yawning. This can help open the eustachian tube and equalize the pressure.
Perform Valsalva maneuver. It is done by closing the mouth, pinching the nostrils, and blowing through the nose. Do this several times until the pressure is equalized. It is more helpful during descent.
When in the cold, sinusitis, infection of the ear, recent surgery of the ear, or nasal congestion, it is essential to reschedule your plan. Do consult with an ENT specialist before making travel plans with any of the above conditions.
Antihistamine medications should be taken when allergies are present.
Filtered earplugs can be used during ascent or descent to equalize the ear pressure. Using earplugs does not lower the need for yawning and swallowing.
When traveling in an airplane cannot be compromised even with severe airplane ears, an ENT specialist might keep tubes in the middle ear to ventilate and equalize the pressure.
If the above precautions are not taken, there will be a severe negative pressure formed in the ear, which causes severe ear pain and induces a block in the eustachian tube due to glue-like secretions produced in the middle ear. This condition is called 'glue ear' or 'serous otitis media.' It needs to be immediately attended to by an ENT (ear, nose, and throat) specialist, or it can lead to a conductive hearing loss. In addition, surgical intervention may be necessary to get the glue formed inside the ear removed.
Ear barotrauma can also lead to:
Permanent hearing loss.
Vertigo results in causing nausea.
While traveling in an airplane, it is necessary to take adequate prophylactic measures to prevent the occurrence of an airplane ear. In addition, simple tricks like swallowing and yawning during a flight can help prevent ear barotrauma. When you experience any of the conditions that make your airplane ear worse, it is necessary to reach out to an ENT specialist to know the possible preventive measures that can be taken. Also, get help from your doctor when you have severe ear pain, discharge, or loss of hearing after a flight.
Last reviewed at:
26 Mar 2022 - 5 min read
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