Have you experienced ear discomfort while flying, especially while the airplane is ascending or descending? Well, this can be airplane ear which is characterized by discomfort, pain, and fullness in the ear. It is caused by sudden pressure changes during air travel.
Airplane ear can affect anybody on the flight but it is more commonly seen in individuals suffering from conditions such as common cold, sinusitis, allergic rhinitis, and middle ear infections. Infants and toddlers are more susceptible to this condition while traveling in air routes.
Airplane ear can be easily prevented by simple techniques such as yawning, chewing, swallowing during the flight. Infants and toddlers can be breastfed, suck a pacifier or drink fluids through a sipper or a straw to ease the symptoms of airplane ear.
This condition is usually self-limiting, responds well to preventive measures, and resolves after air travel.
The typical symptoms of airplane ear include:
In severe cases, an individual may experience:
To understand the cause of airplane ear, it is important to know the normal structure of the ear and how the ear works at ground level
The structure of the ear is divided into three parts:
Outer ear: The part of the ear that is seen from the outside is the outer ear. The external auditory canal connects it to the middle ear. There is a separation between the middle ear and outer ear with a structure called the eardrum.
Middle ear: A tube-like structure called the eustachian tube connects the middle ear to the back of the nose. It plays a very important role in maintaining air pressure on either side of the eardrum.
Inner ear: The inner ear has several compartments that perform specific functions for the purpose of hearing and maintaining balance.
At normal level, the pressure of the air is the same in the middle ear cavity and external ear canal. This equalization of pressure helps in normal functioning of the ear.
Other conditions that can cause ear barotrauma include:
Not everyone suffers from the same intensity of symptoms of airplane ear while flying. This is due to the differences in opening and closing of the eustachian tube. In most of cases, the eustachian tube opens periodically during swallowing, yawning and chewing and tries to maintain equal pressure between the outside and inside of the ear.
However, people with a narrow eustachian tube or any blockages associated with cold, throat infections etc are more prone to develop airplane ear or ear barotrauma.
Everybody on the flight has an effect of the pressure change happening there. But in some individuals the ear pain is worse than others. The following risk factors that block the eustachian tube or hamper its function are associated with airplane ear:
Infants and toddlers are more susceptible to airplane air due to small eustachian tubes.
Some medical conditions make it hard for the ears to adapt to the rapid pressure changes, making one more prone to airplane air. These include:
The activities such as swallowing and yawning helps to equalize the pressure of ears. Since these activities are reduced during sleeping, the chances of airplane air increases if individuals take a nap on flight.
The diagnosis of airplane ear is confirmed based on air travel history and symptoms experienced by the patient. In case of uncertainty about the symptoms, confirmation is done through:
This involves examination of the inner ear through an instrument called an otoscope. The signs that are looked at with an otoscope involves:
This test is performed when a person complains of loss of hearing.
Most of the symptoms of airplane ear are reduced after landing.
When to see a doctor?
A doctor consultation is required if you are experiencing:
The specialty of doctors that may help in diagnosing and treating airplane ears include:
Get the right diagnosis and treatment from our team of qualified doctors.
Airplane ear is a preventable condition. The prevention strategies can be divided into three categories:
It involves measures that can be taken before or during any discomfort in the ears.
1. Practice self-care measures: The activities such as yawning, chewing, and swallowing especially during take off and landing should be performed during flying. These activities help in keeping the eustachian tubes open and thus prevent airplane ear.
Sucking lozenges and chewing gum while the plane begins to ascend and descend is also helpful.
2. Stay awake: Individuals should avoid sleeping or napping during ascent and descent of flights so that they can practice activities such as yawning, chewing, and swallowing. Individuals can also request the attendees of the flight to wake them up when the plane is about to land.
3. Use of air pressure regulating earplugs: There are specialized ear plugs that are often sold at airports, pharmacies, or a hearing clinic. They are helpful in equalizing pressure against the eardrum and thus help in preventing airplane ear.
4. Take medications: Individuals suffering from cold can prevent airplane air by taking decongestants an hour before the take off of the flight.
Note: It is important to take consent from your healthcare provider before taking a decongestant in case of high blood pressure, a heart ailment, a heart rhythm disorder or pregnancy.
5. Use over-the-counter (OTC) nasal sprays: Nasal congestion increases the chances of airplane ear. So, it is recommended to use a nasal spray about 30 minutes before take-off.
6. Blow a special autoinflation balloon: These special balloons have to be blown up through the nose, by blocking off one nostril at a time and blowing through the other. These can be bought from pharmacies, and help people manage pain during flying or unblock ears afterwards.
7. Reschedule air travel plans: If possible, try to reschedule the travel plans by air if you are suffering from common cold, sinusitis, nasal congestion, recent ear surgery or infection, particularly if you have experienced considerable airplane ear symptoms during prior air travel.
It involves strategies to prevent severe ear pain in case of ear discomfort.
1. Valsalva manoeuvre: It is an activity that is performed by passengers feeling ear discomfort during the flight. The technique helps in equalizing pressure in the middle ear and thus help in preventing airplane ear. It involves the following steps:
2. Ear packing
In case of bleeding, immediate ear packing should be done to prevent further damage.
It involves long-term preventive techniques. A tube is placed surgically in the eardrums to help in the fluid drainage and equalize the pressure between the outer and middle ear. It is used for frequent fliers who are prone to severe airplane ear.
Infants and toddlers are more prone to airplane ears due to small eustachian tube.
As a parent or guardian with whom kids are flying, the following measures may help minimize symptoms of airplane ear:
Children more than 4 years of age can try the following:
Note: Decongestants are usually not recommended for children under 6 years of age. Always consult the child’s pediatrician before giving them to the child.
Preventive instructions should also be given by airplane authority about this phenomenon. This will help in spreading awareness and combating the condition. Airplane ear is managed by simple techniques.
The symptoms of airplane ear are mostly self-limiting responds well to preventive measures and usually does not pose any complications. In very rare instances, when eardrum is put under so much pressure that it bursts, it can lead to:
