Overview
Airplane ear, also known as ear barotrauma or aerotitis media, is a condition that occurs when there's a difference in air pressure between the middle ear and the environment, causing stress on the eardrum. This usually happens during takeoff or landing when an airplane is climbing or descending rapidly. The eustachian tubes, which connect the middle ear to the back of the nose and throat, help regulate air pressure. Symptoms can include discomfort, fullness or stuffiness, muffled hearing, and in severe cases, pain, increased ear pressure, hearing loss, ringing in the ear (tinnitus), spinning sensation (vertigo), and bleeding from the ear. To prevent airplane ear, you can yawn and swallow, use the Valsalva maneuver, and avoid sleeping during takeoffs and landings. If symptoms persist or are severe, it's best to consult a doctor.
Understanding the disease
Symptoms
The symptoms of airplane ear include moderate discomfort or pain in the ear, a feeling of fullness or stuffiness in the ear, muffled hearing or slight to moderate hearing loss. If airplane ear is severe, one might experience severe pain, increased ear pressure, moderate to severe hearing loss, ringing in the ear (tinnitus), spinning sensation (vertigo), or bleeding from the ear. If discomfort, fullness, or muffled hearing lasts more than a few days or if you have severe signs or symptoms, it is recommended to call your doctor.
Risk Factors
Risk factors for developing airplane ear include:
- A small eustachian tube, especially in infants and toddlers
- The common cold
- Sinus infection
- Hay fever (allergic rhinitis)
- Middle ear infection (otitis media)
- Sleeping on an airplane during ascent and descent because you aren't actively doing things to equalize pressure in your ears such as yawning or swallowing Airplane ear occurs when the air pressure in the middle ear and the air pressure in the environment don't match, preventing the eardrum from vibrating normally. Swallowing or yawning opens the eustachian tube and allows the middle ear to get more air, equalizing the air pressure. Risk factors can cause the eustachian tube to become blocked or limit its function, making it harder for the pressure to equalize.
Development
Airplane ear, also known as ear barotrauma, occurs when there is a difference in air pressure between the middle ear and the environment, leading to stress on the eardrum. This can result from the rapid changes in air pressure during airplane takeoff and landing, or from other activities such as scuba diving, hyperbaric oxygen chambers, and even driving in the mountains or riding in elevators. In some cases, conditions like a small eustachian tube, a cold, a sinus infection, hay fever, or a middle ear infection can increase the risk of developing airplane ear.
Assessment and Diagnosis
Triage
You should see a doctor if discomfort, fullness, or muffled hearing from airplane ear lasts for more than a few days, or if you have severe signs or symptoms, such as severe pain, increased ear pressure, moderate to severe hearing loss, ringing in your ear (tinnitus), spinning sensation (vertigo), or bleeding from your ear.
Diagnosis
To diagnose airplane ear, a doctor will typically examine your ear with a lighted instrument called an otoscope and may also use a pneumatic otoscope to assess the movement of the eardrum. They will also take into account your symptoms and medical history, including recent airplane travel, colds, sinus infections, or ear infections. If there is any doubt about the diagnosis or if the condition has not responded to previous treatments, additional tests may be performed.
Management and Treatment
Complications
Potential complications of airplane ear may include:
- Permanent hearing loss
- Ongoing (chronic) tinnitus (ringing in the ear)
- Spinning sensation (vertigo)
- Bleeding from the ear These complications typically occur in severe cases or when the condition is prolonged or damages middle or inner ear structures. It's important to seek medical attention if symptoms persist or worsen.
Prevention
Airplane ear can be prevented by following certain tips to equalize the pressure in the ears during ascent and descent. These include yawning and swallowing, using the Valsalva maneuver, and avoiding sleep during takeoffs and landings. It's also recommended to reconsider travel plans during colds, sinus infections, nasal congestion, or ear infections. For young children, encouraging frequent swallowing and avoiding decongestants can help prevent airplane ear. In severe cases or for people who frequently fly, consulting a doctor about surgical options to aid fluid drainage and equalize pressure may be necessary.
Home Remedies
For airplane ear, home remedies include:
- Yawning and swallowing: Yawn and swallow during ascent and descent to activate the muscles that open your eustachian tubes. You can also suck on candy or chew gum to help you swallow.
- Valsalva maneuver: Gently blow, as if blowing your nose, while pinching your nostrils and keeping your mouth closed. Repeat several times, especially during descent, to equalize the pressure between your ears and the airplane cabin.
- Avoiding sleep: Don't sleep during takeoffs and landings so that you can do the necessary self-care techniques when you feel pressure in your ears.
- Reconsidering travel plans: If possible, avoid flying when you have a cold, a sinus infection, nasal congestion, or an ear infection. If you've recently had ear surgery, consult your doctor about when it's safe to travel. Remember, these home remedies are usually effective in managing airplane ear. However, if you experience severe symptoms, consult a doctor for further evaluation and treatment.
Treatment
To treat airplane ear, you can try the following:
- Valsalva maneuver: Pinch your nostrils shut, close your mouth, and gently force air into the back of your nose, as if you were blowing your nose. This can help equalize the pressure in your ears.
- Decongestants: Oral decongestants or decongestant nasal sprays can help reduce inflammation and congestion, which may contribute to airplane ear.
- Pain relievers: Take nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Advil, Motrin IB, others) or naproxen sodium (Aleve), or analgesic pain relievers like acetaminophen (Tylenol, others) to alleviate discomfort.
- Self-care therapies: Use over-the-counter ear drops, such as hydrogen peroxide or olive oil, to help alleviate symptoms. In cases where symptoms persist, your doctor may recommend additional treatments, including oral medications or, in rare cases, a surgical procedure like a myringotomy to equalize air pressure and drain fluids. It is important to consult with your doctor if your symptoms are severe or do not improve with self-care techniques. They can provide guidance on the best course of treatment for your specific situation. Remember, it's crucial to see a healthcare professional if you experience severe pain, bleeding from the ear, hearing loss, or facial weakness, as these may be indications of a more serious condition.
Preparing for medical consultation
To prepare for an appointment for airplane ear, make a list of the following:
- Your symptoms and when they began
- Any medications, vitamins, or supplements you are currently taking, including doses
- Your medical history, including any allergies, past ear infections, or previous experiences with airplane ear
- Questions for your doctor, such as best treatment, prevention tips, etc. By having this information ready, you can ensure a more productive discussion with your doctor and receive the most appropriate treatment plan for your airplane ear.