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Ear barotrauma, also known as airplane ear, occurs when there is an imbalance in air pressure between the middle ear and the surrounding environment, leading to potential damage. This condition commonly arises during airplane travel when the aircraft ascends after takeoff or descends for landing.
To alleviate symptoms of airplane ear, simple self-care measures can be taken. Actions like yawning, swallowing, or chewing gum can help equalize the air pressure and relieve discomfort. These steps are usually effective in managing mild cases. However, if the symptoms of airplane ear are severe, it is advisable to seek medical attention from a doctor.
Symptoms
Airplane ear can affect one or both ears. Typical indications and symptoms include:
- Moderate discomfort or pain in the ear
- Sensation of fullness or blockage in the ear
- Hearing sounds muffled or experiencing mild to moderate hearing loss.
- Moderate to severe hearing impairment
- Tinnitus (ringing in the ear)
- Vertigo (spinning sensation)
- Bleeding from the ear
If the sensations of discomfort, fullness, or muffled hearing persist for more than a few days, or if you experience severe signs or symptoms, it is advisable to contact your doctor.
Causes
Ear barotrauma occurs when there is a sudden change in air or water pressure, causing pressure to be exerted on the eustachian tubes. These tubes connect the back of the middle ear to the back of the throat and play a role in equalizing air pressure on both sides of the eardrum by allowing outside air to enter the middle ear.
Air pressure changes occur rapidly during airplane takeoff and landing, surpassing the ability of the eustachian tubes to adjust accordingly. Similarly, deep-water diving can lead to rapid changes in water pressure, resulting in the same problem. If you have congestion due to a cold or allergies, the risk of experiencing ear barotrauma increases. Congestion can block or inflame the eustachian tubes, making it even more difficult for them to manage the changes in air pressure.
Risk factors
Airplane ear can be more likely to occur when certain conditions obstruct or impair the function of the eustachian tube. Several common risk factors include:
- Small eustachian tube: Infants and toddlers, in particular, may have narrower eustachian tubes, which can make them more susceptible to airplane ear.
- The common cold: Having a cold can lead to congestion and inflammation of the nasal passages and eustachian tubes, making it harder for air to equalize and increasing the risk of airplane ear.
- Sinus infection: Infections in the sinuses can cause nasal congestion and inflammation, affecting the eustachian tube’s ability to equalize pressure during air travel.
- Hay fever (allergic rhinitis): Allergic reactions, such as hay fever, can cause nasal congestion and swelling, which can interfere with proper eustachian tube function.
- Middle ear infection (otitis media): An ongoing or recent middle ear infection can disrupt the normal functioning of the eustachian tube and make airplane ear more likely.
- Sleeping on an airplane during ascent and descent: If you are asleep during takeoff or landing, you may not actively perform actions like yawning or swallowing, which help equalize pressure in the ears. This can increase the risk of experiencing airplane ear symptoms.
Diagnosis
When you visit your doctor, they will likely be able to diagnose your condition by taking into account your medical history and conducting an examination of your ear using an otoscope, which is a tool with a light that allows them to look inside your ear. They will inquire about your symptoms and how long you have been experiencing them. Additionally, they may refer you to an audiologist for a hearing test if necessary.
Treatment
In most cases, airplane ear typically resolves on its own over time. However, if the symptoms persist, it may be necessary to undergo treatments aimed at equalizing pressure and alleviating discomfort.
- Medications: To alleviate your symptoms, your doctor may recommend using decongestant nasal sprays or oral decongestants. In order to relieve any discomfort, you can take over-the-counter nonsteroidal anti-inflammatory drugs like ibuprofen (Advil, Motrin IB) or naproxen sodium (Aleve), as well as analgesic pain relievers such as acetaminophen (Tylenol).
- Surgery: In most cases, surgery is not needed to treat airplane ear. Even severe injuries, such as a ruptured eardrum or inner ear membrane, typically heal on their own. However, in rare cases, a procedure called myringotomy may be necessary. This involves making a small incision in the eardrum to help equalize air pressure and drain any fluids.
- Self-care therapies: During drug treatment for airplane ear, your doctor may recommend the use of the Valsalva maneuver. This technique involves pinching your nostrils shut, closing your mouth, and gently exhaling to force air into the back of your nose, similar to the action of blowing your nose.
