“Airplane ears,” medically known as ear barotrauma, is a common condition experienced by air travelers. This discomfort is caused by stress on the eardrum when air pressure inside the middle ear and outside the ear become unbalanced. It frequently occurs during the rapid altitude changes of airplane ascent shortly after takeoff and, more commonly, during descent before landing. Understanding the underlying mechanism allows for effective prevention and relief.
How Pressure Affects the Middle Ear
The middle ear, an air-filled space behind the eardrum, requires its internal pressure to match the external air pressure for comfortable hearing. This equalization is managed by the Eustachian tube, a narrow channel connecting the middle ear to the back of the nose and throat. Normally, this tube opens when you swallow or yawn, allowing air to move in or out to stabilize the pressure.
During an airplane’s rapid ascent, the cabin pressure decreases, causing the air in the middle ear to expand. If the Eustachian tube does not open quickly enough, the expanding air pushes the eardrum outward, leading to a feeling of fullness or a slight pop. Conversely, during descent, the cabin pressure increases, pushing the eardrum inward. This causes discomfort or pain because the Eustachian tube may not open fast enough to let air into the middle ear to balance the pressure.
Immediate Relief and Preventive Measures
When ear discomfort begins during a flight, simple actions can help equalize the pressure instantly. Swallowing and yawning are highly effective because these actions activate the muscles that force the Eustachian tubes open. Chewing gum or sucking on hard candy promotes frequent swallowing, which helps keep the tubes active during critical periods like descent.
For stubborn blockages, the Valsalva maneuver involves gently pinching the nostrils shut, closing the mouth, and blowing softly, as if blowing the nose. This action should create a slight popping sensation as air is forced into the middle ear, but it must be done with caution and without excessive force to avoid eardrum injury. For infants, encouraging them to suck on a bottle or pacifier during ascent and descent is a simple way to promote the necessary swallowing motions.
Preventive steps taken before and during the flight can significantly reduce the risk of barotrauma. Using specialized pressure-regulating earplugs can slow the rate of pressure change reaching the eardrum, giving the Eustachian tube more time to adjust. Taking an over-the-counter decongestant, such as a nasal spray or oral tablet, about 30 to 60 minutes before takeoff and again before landing can help reduce swelling in the nasal passages, keeping the Eustachian tubes clear. Avoid flying if you have an active cold, sinus infection, or severe allergies, as congestion severely limits the Eustachian tube’s ability to equalize pressure.
Signs of Severe Barotrauma
While most cases of ear barotrauma resolve on their own, certain symptoms indicate a more severe condition requiring medical attention. Persistent, severe pain lasting hours or days after landing should prompt a visit to a healthcare provider. Other concerning signs include significant hearing loss or a muffled sensation that does not improve within a day. The sudden appearance of persistent ringing in the ears (tinnitus) or a spinning sensation (vertigo) indicates potential inner ear damage. Any visible fluid or blood leaking from the ear canal may signal a ruptured eardrum, which needs immediate professional evaluation.