The sensation of pressure and discomfort in the ears during air travel, known as “airplane ears,” is a common complaint. This temporary distress occurs most often during the aircraft’s ascent and, more noticeably, its descent. While the feeling is usually fleeting, it can sometimes escalate into significant pain and muffled hearing. Understanding the underlying science and knowing how to manage it can improve the travel experience.
Understanding Ear Barotrauma
The medical term for this condition is ear barotrauma, or aerotitis media, which describes the injury or discomfort caused by pressure differences across the eardrum. Barotrauma is essentially a stress injury resulting from an imbalance between the air pressure in the middle ear and the external environment. The condition can manifest with a range of symptoms, from mild annoyance to considerable pain.
Commonly reported sensations include a feeling of fullness or stuffiness in the ear. This is often accompanied by muffled hearing. In more acute cases, travelers may experience sharp pain and a temporary reduction in hearing. Relief is often signaled by a distinct “pop” sound, indicating that the pressure has successfully equalized.
The Mechanism of Pressure Changes
The root cause of ear barotrauma lies with the Eustachian tube, a narrow passage that connects the middle ear to the back of the nose and throat. This tube’s primary function is to maintain equal air pressure on both sides of the eardrum. It typically remains closed, opening briefly when a person swallows, yawns, or chews, allowing air to flow in or out of the middle ear space.
During air travel, the cabin pressure changes rapidly, particularly during descent. As the aircraft descends, the external atmospheric pressure increases quickly. If the Eustachian tube does not open quickly enough to let air into the middle ear, a pressure vacuum develops. This negative pressure differential pulls the eardrum inward, causing strain, pain, or blockage. Any condition causing inflammation or swelling, such as a cold, allergies, or a sinus infection, can block the Eustachian tube and make pressure equalization more difficult.
Immediate Relief and Management Techniques
Proactive preparation and timely self-care maneuvers are the most effective ways to manage and prevent pressure discomfort during a flight. Simple behavioral techniques, such as swallowing, chewing gum, or intentionally yawning, help activate the muscles that open the Eustachian tubes. Chewing gum or sucking on hard candies during takeoff and landing encourages frequent swallowing, which helps keep the air passages open.
A common technique for actively forcing the tube open is the Valsalva maneuver, which should be performed gently. This involves closing the mouth, pinching the nostrils shut, and then attempting to exhale air with moderate force, as if gently blowing the nose. The resulting surge of air passes through the Eustachian tube into the middle ear, often producing the desired “pop” sensation. Perform this maneuver before the pressure imbalance becomes severe, and avoid blowing too forcefully, which could cause injury.
Travelers with existing congestion from a cold or allergies can benefit from medical preparation. Taking an oral decongestant containing pseudoephedrine about an hour before the flight may help reduce swelling in the nasal passages, aiding Eustachian tube function. Nasal decongestant sprays, such as those containing oxymetazoline, can also be applied 30 minutes before descent to shrink the mucous membranes near the tube opening.
Specialized pressure-regulating earplugs contain a ceramic filter designed to slow the rate of pressure change reaching the eardrum. This delay provides the ear’s natural mechanisms more time to adjust to the cabin environment. Parents traveling with infants should encourage swallowing by offering a bottle or pacifier during the descent, as the swallowing motion is a natural equalizer.
When Discomfort Becomes a Medical Concern
While airplane ear is usually temporary, symptoms can occasionally persist or worsen, indicating a more serious problem. Mild discomfort and muffled hearing should resolve within a few minutes to a few hours after landing. If the pain is severe or if the sensation of fullness lasts for more than a few hours, professional medical evaluation may be warranted.
Signs that suggest a complication of barotrauma include extreme ear pain that does not subside, a noticeable decrease in hearing that lasts for days, or the onset of severe dizziness known as vertigo. Fluid or blood draining from the ear canal is a sign of potential eardrum rupture, which requires immediate medical attention. In rare instances, severe barotrauma can cause damage to the inner ear structures, leading to chronic hearing loss or persistent ringing in the ears.