When an airplane begins its descent, many travelers experience discomfort, from a feeling of fullness in the ears to a sharp headache. This common phenomenon, often called “airplane ear” or ear barotrauma, is physical discomfort directly linked to changing atmospheric pressure during air travel. It can be distracting and painful, affecting many individuals on flights.
Why It Happens
The human ear contains a small, air-filled chamber called the middle ear, connected to the back of the nose and throat by the Eustachian tube. This tube equalizes air pressure inside the middle ear with the external environment, opening to maintain balanced pressure on both sides of the eardrum.
During an airplane’s descent, cabin pressure rapidly increases. The air pressure outside the eardrum becomes higher than inside the middle ear. If the Eustachian tube does not open quickly enough, a pressure imbalance occurs. This imbalance pulls the eardrum inward, leading to discomfort, fullness, or pain.
This condition is known as ear barotrauma, which is damage to the ear caused by a sudden change in air pressure. Sinuses, air-filled cavities in the skull, can also be affected. If these passages are blocked, trapped air creates a pressure difference, causing pain in the forehead, cheeks, or around the eyes, a condition called aerosinusitis or sinus barotrauma. Both ear and sinus barotrauma stem from the body’s struggle to adapt to rapid pressure shifts.
Strategies for Relief and Prevention
Managing discomfort during airplane descent involves proactive steps to help the Eustachian tubes equalize pressure. Swallowing activates the muscles that open the Eustachian tubes. Chewing gum, sucking on hard candy, or sipping water during descent promotes frequent swallowing, assisting in pressure equalization.
The Valsalva maneuver is another effective technique: with a closed mouth and pinched nostrils, gently blow air as if trying to exhale through the nose. This action forces air into the Eustachian tubes, helping them open and equalize pressure. Perform this gently to avoid ear damage. Yawning widely also helps open the Eustachian tubes and relieve pressure.
Decongestants reduce swelling in the nasal passages and around Eustachian tube openings, making it easier for pressure to equalize. Over-the-counter nasal sprays (e.g., oxymetazoline) or oral decongestants (e.g., pseudoephedrine) can be taken 30-60 minutes before descent.
Staying hydrated throughout the flight keeps mucous membranes moist, supporting Eustachian tube function. Avoiding sleep during descent allows individuals to actively perform these techniques. Special earplugs designed for flying can also slow pressure changes, giving the ears more time to adjust.
When to Consult a Doctor
While airplane ear often resolves with self-care, certain symptoms warrant medical attention. If ear discomfort, fullness, or muffled hearing persists for more than a few days after a flight, or if symptoms are severe, a medical appointment is advisable. Severe pain, fluid oozing from the ear, or bleeding from the ear require immediate evaluation, as they could indicate a ruptured eardrum.
Underlying conditions can exacerbate airplane ear. Chronic sinus issues, allergies, or ear infections can cause inflammation and block the Eustachian tubes, making pressure equalization difficult and increasing the risk of severe symptoms.
Dizziness or vertigo associated with ear pain also suggests a need for professional assessment. Consulting a healthcare provider, possibly an ENT specialist, can help diagnose pre-existing conditions and determine treatment to prevent future occurrences. In some cases, persistent issues may lead to complications like lasting hearing loss or chronic ringing in the ears.