Ear problem is a very common medical complaint of people who travel often by airplane. The sudden and rapid change in air pressure during ascent and descent of airplane can create a vacuum in the middle ear and cause a blocked sensation. While most ear discomfort during air travel could be annoying, for some people, it becomes a problem as it results in ear pain. This temporary discomfort caused, especially during air travel is called as airplane ears.
Understanding airplane ears
Airplane ears occur when stress is applied on the ear drum due to unbalanced air pressure in the middle ear and the outer environment. Airplane ears cause temporary pain and hearing loss that may affect one ear or both the ears. Airplane ears are also called as ear barotrauma, barotitis media or aerotitis media. Usually airplane ears are not serious, and can be treated by yawning, swallowing or chewing, which corrects the difference in air pressure and minimizes the symptoms. However, in some cases, the airplane ear may require medical intervention.
Causes
Knowing structure and function of ear can help us understand how airplane ears occur. The middle ear has a small tube like structure called Eustachian tube that connects the middle ear with the outer ear in front and at the back it opens in the rear end of the nose. In normal condition the air passes freely from atmosphere through the nose, Eustachian tube, and the middle ear thereby maintaining the air pressure inside the ear equal to the outer atmospheric pressure. But in few patients with cold and allergies the small passage where the Eustachian tube ends in the nose is blocked or congested by nasal secretion. This blockage prevents easy flow of air. During air travel, mostly during descent when the air contracts, the mucus and other blockages acts like a flap over the end of nose and allows the air to travel only one way, it allows the air to move out but does not allow the air to enter in. This creates a vacuum inside the middle ear, which sucks the surrounding tissue causing pain and temporary hearing loss. People who do not suffer from cold and allergy also experience airplane ears as the Eustachian tube is unable to adjust to the sudden change in air pressure during ascend and descend of the airplane. Airplane ears may be caused during
- Scuba diving or underwater diving for a long period of time
- Air travel
- Nearby explosion
- Being slapped or hit on the ear
- Trekking or driving in mountains
Symptoms
People with airplane ears typically experience mild ear pain and discomfort, as well as a feeling of being full or stuffed in the ear. They may also experience temporary hearing loss.
In severe airplane ear that lasts for more than a few hours, symptoms include ear pressure and intense pain. There may be moderate or severe hearing loss along with a feeling of vertigo or spinning sensation. Vertigo may also cause vomiting. The person may have tinnitus (ringing sound in the ear) and in rare cases, ear bleeding.
Complications
Airplane ear is not a serious condition, and it usually goes away on its own after a few simple self-care methods. However, in a small number of cases, serious and long-lasting complications can occur if your inner and middle ears are damaged. In very rare cases, it can lead to tinnitus (ringing in the ears) or even permanent hearing loss.
Diagnosis
A detailed history of the symptoms experienced and a physical examination will be done. Any recent flight journey should be informed to the doctor. The doctor will examine the patient’s ear drum using a special flashlight instrument called the otoscope. If the patient is suffering from airplane ears then the doctor can see a bulge in the ear drum, which is caused due to difference in air pressure. In severe condition the doctor might also be able to see blood behind the ear drum. If the patient complaints about vertigo then the inner ear will be examined to check for any damage to the inner ear structure. An audiometry or hearing test will also be done to check how well the patient can hear and to what extent the hearing capacity is impaired.
Treatment
A consultation with a physician would be advisable, as they may be able to provide the most suitable treatment. To reduce the pressure in the ear canal, the patient can try to chew gum, swallow, yawn, suck on candy, and inhale and exhale through the nose while gently pressing the nostrils shut. In the event of an allergy or cold that leads to nasal congestion or ear canal blockage, the physician may prescribe medications such as decongestants, nasal sprays, oral antihistamines, and pain-relieving medicines. In more severe cases, antibiotics may be prescribed to protect against infection. If all of these treatments have not been successful, surgery may be the last resort, which involves making a small incision in the eardrum to reduce pressure on both sides and remove any fluid that may be obstructing the tube.
Prevention
Few steps you can take to prevent airplane ears –
- During air travel yawn and swallow often.
- Blow nose by pinching nostrils and closing mouth.
- Avoid sleeping during ascent and descent.
- Avoid air travel if suffering from cold, nasal congestion, ear infection, and sinus infection.
- Use a nasal decongestant spray or pills 30 minutes before travel.
- Take allergy medicines an hour before the flight.
- Use earplugs to help equalize air pressure.
- Drink plenty of water and juice to avoid irritation of nasal passage and throat.
- Do not drink alcohol or caffeine.
- For babies, have them suck a bottle or a pacifier.
Outlook
Airplane ear is a very common condition and many of the readers might have experienced it themselves. It is not a disease or a very serious condition that requires immediate medical attention. The sufferer can be relieved by just following simple tricks to release the pressure inside the ear. However, if the symptoms persist for an extended period of time after an air journey, it is advisable to consult a doctor as they can determine the exact cause of the discomfort. It is important to be adequately prepared prior to air travel.
