Airplane ear also known as aerotitis media or barotitis media is a form of barotrauma of ear. It results from an imbalance in the air pressure between your middle ear and the environment. It usually happens during the beginning and the descent of flight journeys. Airplane ear is triggered due to sudden or fast changes in the altitude and air pressure.
What are the symptoms?
Airplane ear can affect one or both the ears. The symptoms and signs are:
- Discomfort or pain in the ear
- Stuffiness in the ear
- Muffled hearing
- Slight hearing loss
In case of long journeys, if the airplane ears last for more than few hours, the symptoms may be:
- Severe pain
- Moderate to severe hearing loss
- Increased pressure in the ear
- Ringing sound in the ear (tinnitus)
- Dizziness and vertigo (spinning sensation)
- Bleeding from the ear
What are the causes?
Airplane ears occur when there is an imbalance in the air pressure between the middle ear and the air pressure in the environment. This air pressure imbalance prevents your eardrum from vibrating to sound as usual.
Air pressure is maintained similar on both the sides of tympanic membrane by a tube called the Eustachian tube. This tube connects the middle ear to the back of the mouth. When the flight goes up or descends, the air pressure inside the plane changes rapidly, and the Eustachian tube often does not work quickly enough, leading to a difference in the pressure between the inside and the outside of the ear. This condition can also occur during:
- Scuba diving
- Hyperbaric oxygen chambers
- Driving in the mountains
- Riding an elevator of a tall building
What are the risk factors?
Any condition that leads to blockage of Eustachian tube or restricts its function can increase the risk of airplane ear. These includes:
- Common cold
- Small size of Eustachian tube in infants and toddlers
- Running nose
- Middle ear infection
- Sleeping during ascent and descent of aeroplane
How is it diagnosed?
The doctor usually diagnoses this condition based on your explanation of the situation, when it started and the symptoms. He/she also does an examination of the ears with an instrument called as the otoscope. They may notice a slight inward or outward bulging of your eardrum. The doctor may suggest you to go for a hearing test to find out how well is your hearing capacity and whether there is any problem in your inner ear.
What is the treatment?
Usually, airplane ear gets better by itself after some time. Only when the symptoms persist, you may require treatment to relieve symptoms and equalise pressure. Treatment may include:
- Nasal sprays
Along with the medication, the doctor will ask you to do Valsalva manoeuvre. In this manoeuvre, you have to close your nostrils and mouth and gently try to blow air into the back of the nose till you hear a “pop” sound which means the Eustachian tube has opened up. This therapy helps in opening up the Eustachian tubes and balancing the air pressure across both the sides of the tympanic membrane.
What are the complications?
Airplane ear usually doesn’t cause any complications and it responds well to self-care. Long-term complications can occur if there is some damage to the middle or inner ear. This can include:
- Permanent loss of hearing
- Chronic tinnitus
How to prevent airplane ear?
You can follow these simple tips to avoid airplane ear:
Yawning and swallowing. Yawning and swallowing during take-off and landing of airplane helps in opening up the Eustachian tubes. Chewing gum or candy may also help due to the same reasons.
Valsalva manoeuvre. You can do Valsalva manoeuvre during take-off and landing of the airplane.
Avoid sleeping. Try not to sleep during ascent and descent of airplane.
Use nasal spray. If you have a blocked nose, use decongestant nasal spray 30 minutes before your flight.
Take decongestants: If you have to fly with a cold or infection, take a decongestant pill about 1 hour before the flight.
Take anti-allergics. If you have any allergy, take your medicines about 1 hour before the flight.
How to help children in preventing airplane ear?
- Hold or place the child upright at the time of take-off and landing
- A pacifier can help a baby in swallowing
- Baby or toddler can sip juice or suck a candy during ascent and descent of airplane.
- Older children can have a chewing gum or drink from a straw or blow bubbles through a straw
When to consult a doctor?
If the ear pain persists several hours after landing, you may consult a doctor. Also, if you have severe pain, bleeding or leakage of fluid from the ears, you should see a physician, because these are the symptoms of a ruptured eardrum.
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- Barotrauma. https://medlineplus.gov/barotrauma.html. Accessed on 24th August 2016.
- Barotrauma. http://www.health.harvard.edu/diseases-and-conditions/barotrauma. Accessed on 24th August 2016.