Airplane Ear

Lindsay Block, M.D.

Many of us have experienced Airplane Ear, also called barotrauma, during air travel. Airplane ear is caused by an imbalance in the air pressure in the middle ear space and the air pressure in the environment. Most people experience airplane ear during take-off when the plane is ascending quickly, or during landing when the plane is descending. During these times, the fast changes in altitude cause rapid air pressure changes as well, and often the eustachain tube does not react fast enough.

The eustachian tube is a narrow passage that connects the middle ear space to the nasopharynx, which is where the back of the nasal cavity and the top of the throat meet. The job of the eustachian tube is to regulate air pressure within the middle ear cavity, so that your eardrum (also called the tympanic membrane) can vibrate in response to sound. The eustachian tube is typically closed over, but by yawning and swallowing, we activate muscles that will open the eustachian tube and refresh the air supply of the middle ear. There are certain conditions that will affect the function of the eustachian tube and limit its ability to open such as a common cold, hay fever (also called allergic rhinitis) or a sinus infection.

One method that can be used to help open the eustachian tube is called the Valsalva maneuver. To do this, you need to pinch your nostrils shut, close your mouth and then gently force air towards the back of your nose, like when you blow your nose. This method can be used during take-off and landing on the airplane to help keep the middle ear pressure equalized to the cabin pressure.

In order to prevent airplane ear, there are several self-care methods that you can follow:

Yawning and swallowing during take-off and landing. Some people chew gum or suck on hard candies to encourage more swallowing and help activate the muscles that open the eustachian tube.

Using an over-the counter decongestant nasal spray. By taking a nasal decongestant approximately 30-60 minutes prior to take off and landing, it can help to relieve nasal congestion. However, you need to be careful of overuse because they can actually increase congestion if taken over several days.

Oral decongestant pills can also be helpful when taken approximately 30-60 minutes prior to a flight. However, these pills need to be used cautiously as it is not recommended for use with everyone. People with heart disease, high blood pressure, a heart rhythm disorder or pregnant women should consult with their doctors before taking any of these medications.

Drink plenty of water in order to avoid dehydration. Being dehydrated can cause irritation of the nasal passages and throat, which may affect the eustachian tubes.

Remain awake during ascent and descent so that you are aware of any feelings of pressure in your ears and you can perform any necessary self-care techniques.

• Some people benefit from the use of filtered ear plugs, called EarPlanes. These ear plugs slow the rate of ear pressure changes against the ear drum. They can usually be found at drugstores or airport gift shops, and are available in adult and children’s sizes.

Should you experience any severe pain or symptoms such as ear pressure, hearing loss, tinnitus, dizziness or ear drainage, you should see your primary care physician or an Otolaryngologist (ENT).