Discover tips to prevent and relieve airplane ear discomfort. Your guide to a pain-free flight. Meri Sehat keeps you flying comfortably.

Airplane Ear

A. JABBAR DENTAL CLINIC

Sadia Khan

Overview

Airplane ear is discomfort or pain that occurs when there is a pressure difference between the external environment and the middle ear. 
&nbsp;

Airplane ear, also known as ear barotrauma or barotitis media, is a common medical problem associated with air travel.However, sudden changes in water pressure in the environment can also cause damage to the middle ear(s), as seen during scuba diving.

A vacuum develops in the middle ear due to the pressure change, and it pulls the eardrum inward. Consequently, the individual experiences pain and hears muffled sounds. While it&rsquo;s generally not considered a serious medical issue, some severe cases may cause a ruptured eardrum, leading to hearing loss, <a href="https://merisehat.pk/disease/vertigo">vertigo</a>, and a middle ear infection. 
&nbsp;

Airplane ear can happen to anyone, though some individuals may feel the pain worse than others, and some do not feel it at all. According to some studies, around 500-1000 incidents of nonfatal dive injuries are reported every year in Canada and the USA.<a href="#accordion">[1]</a>&nbsp;Generally,1 in 3 passengers, or 22% of children and 10% of adults, develop this condition after a flight.<a href="#accordion">[2][3]</a> 
&nbsp;

Sign and Symptoms

An airplane ear can occur in one or both ears. Hallmark signs of ear barotrauma include:

<ul>
	<li>General ear discomfort</li>
	<li>Temporary hearing loss</li>
	<li>Tinnitus or ringing in the ear</li>
	<li>A sensation that ears are stuffed</li>
	<li>A need to &ldquo;pop&rdquo; open the ears 
	&nbsp;</li>
</ul>

More severe signs include:<a href="#accordion">[1][4]</a>

<ul>
	<li>Feeling of pressure in the ear (as if underwater)</li>
	<li>Sharp or throbbing pain in the ear</li>
	<li>Bleeding from the ear</li>
	<li>Dizziness and disorientation</li>
	<li>Nausea and vomiting</li>
	<li>Hearing loss</li>
	<li>Nosebleed 
	&nbsp;</li>
</ul>

Note

<ul>
	<li>Consult a doctor if the discomfort and hearing loss last more than a few days or if you experience any severe signs or symptoms.</li>
	<li>Some situations that cause airplane ears can also damage the sinuses and lungs. To prevent any severe damage from occurring, &nbsp;you need to look out for additional symptoms, such as shortness of breath, as well.<a href="#accordion">[5]</a> 
	&nbsp;</li>
</ul>

Causes

The air pressure changes with a rapid change in altitude. It increases as we go lower and decreases as we go higher or above sea level. Hence, flying, climbing a mountain, riding an elevator, scuba diving, exposure to an explosive blast, and hyperbaric oxygen therapy are some circumstances that create this difference between the environment and the middle ear, causing pain for those few minutes until the eustachian tubes balance or equalize the air pressure on both sides of the eardrums.<a href="#accordion">[5]</a>

Another reason could be an underlying problem with the eustachian tube. It could be a fluid buildup or inflammation in the area due to sinus congestion, anatomical abnormalities, allergies, a cold, hormonal changes, or exposure to irritants. 
&nbsp;

Diagnosis

Diagnosis depends mainly on the medical history and physical examination of the individual. The doctor would inquire about past episodes and the frequency of their occurrence, including their diving history.

They would then look inside the middle ear with an otoscope to assess any damage to the eardrum. Furthermore, the doctor may order tests, such as a hearing test and an MRI of the ear, to see if there is any other problem. 
&nbsp;

Treatment

The majority of cases do not need any treatment and go away on their own. Individuals can relieve pressure using the following first-aid measures:

<ul>
	<li>Chew gum</li>
	<li>Swallow or yawn frequently</li>
	<li>Valsalva maneuver, i.e., close the mouth and pinch the nostrils shut and then try to breathe through the closed nose 
	&nbsp;</li>
</ul>

However, for mild or persistent injuries, the healthcare provider may prescribe decongestants, NSAIDs, or analgesics to alleviate symptoms. Severe ear infections may be treated with antibiotics. Rarely, the person may require surgical intervention to treat ruptured eardrums or chronic cases of ear barotrauma. 
&nbsp;

Sometimes, complications can arise if the condition is left untreated or if it is a chronic case.<a href="#accordion">[1][6]</a>

<ul>
	<li>Acute ear infection</li>
	<li>Chronic tinnitus</li>
	<li>Permanent hearing loss</li>
	<li>Decompression sickness (for divers)</li>
	<li>Accidents, like drowning due to disorientation 
	&nbsp;</li>
</ul>

Common risk factors include:

<ul>
	<li>Underlying health issues, such as hay fever</li>
	<li>Panic disorders</li>
	<li>A small eustachian tube, especially in infants or toddlers</li>
	<li>Poor training or inexperience</li>
</ul>

Lack of proper gear, especially for scuba divers or military personnel. 
&nbsp;

It is possible to prevent an airplane ear in most cases by doing the following:

<ul>
	<li>Use filtered earplugs when flying an airplane</li>
	<li>Follow safe diving practices for scuba diving</li>
	<li>Avoid flying or diving when sick (e.g., have a cold, allergy, or ear infection) or consult a doctor for medication if it cannot be rescheduled</li>
	<li>Do not sleep during ascents or descents 
	&nbsp;</li>
</ul>

Since children may not be able to follow instructions like yawning or swallowing on time to prevent an airplane ear, parents can:

<ul>
	<li>Give the baby or toddler something to suck on (e.g., a pacifier) to encourage swallowing</li>
	<li>Encourage them to drink water during landing or taking off and, at the same time, ensure that they are sitting up while drinking</li>
	<li>Children 4 years of age or older can blow bubbles through a straw or blow their nose gently into a tissue 
	&nbsp;</li>
</ul>

Key Points

<ul>
	<li>Airplane ear is discomfort or pain that occurs when there is a pressure difference between the external environment and the middle ear.</li>
</ul>

<ul>
	<li>Symptoms include ear pain, temporary hearing loss, and the sensation that ears are stuffed</li>
</ul>

<ul>
	<li>Common causes are rapid altitude changes and eustachian tube dysfunction.</li>
	<li>Treatment options include decongestants and, in severe cases, surgery.</li>
</ul>