Ear barotrauma or airplane ear is the stress exerted on your eardrum and other middle ear tissues.
It appears when the air pressure in your middle ear and the air pressure in the environment are out of balance.
Ear barotrauma usually appears at the beginning of a flight when the airplane is climbing or at the end of a flight when the airplane is descending.
Airplane ear is also called ear barotrauma, barotitis media, or aerotitis media.
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Increased pressure on ears
The air pressure inside the inner ear and the air pressure outside are mostly the same. When the plane begins its ascent, the air pressure inside the inner ear quickly surpasses that of the pressure outside which can cause problems.
If air pressure inside the inner ear rapidly becomes less than the air pressure outside, the tympanic membrane will be sucked inward, almost like a vacuum effect.
What has happened is that the Eustachian tube has flattened and needs a bit of help from you to continue to do its job of bringing air into the inner ear, and the stretching of the eardrum can cause pain.
During this time, the eardrum is not able to vibrate, so you also experience decreased hearing and muffled sounds.
Causes of ear barotrauma
One of the most common causes of ear barotrauma is blockage of the Eustachian tube.
The eustachian tube helps to restore equilibrium during changes in pressure, and when it’s blocked, symptoms develop because the pressure in the ear is different than the pressure outside of your eardrum.
Altitude changes are the most common cause of this condition, and the other situations that might cause ear barotrauma include:
- Scuba diving
- Driving through mountains
Read More: About Hearing Loss >
Common risk factors
Any condition that blocks the Eustachian tube or limits its function can increase the risk of airplane ear. Common risk factors 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
Ear barotrauma treatment
Most barotrauma injuries heal on their own with time, and your symptoms will go away, but the eardrum may not heal as normal if a blast caused the injury.
That’s usually determined by referring to an ear, nose, and throat doctor (ENT or otolaryngologist).
Your doctor may tell you to rest in bed with your head raised on a pillow, keep your ear dry, and how to prevent your affected ear from getting wet when taking a bath or shower.
You may help relieve the effects of air pressure on your ears by:
- Chewing gum
- Breathing exercises
- Taking antihistamines or decongestants
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Medicines, surgery, and recovery period
Your doctor may prescribe medications or direct you to take over-the-counter medications to control conditions that may prevent the eustachian tubes from functioning well.
These drugs may include:
- Decongestant nasal sprays
- Oral decongestants
- Oral antihistamines
To ease discomfort, you may want to take:
- The nonsteroidal anti-inflammatory drug, such as ibuprofen (Advil, Motrin IB)
- Naproxen sodium (Aleve)
- Analgesic pain reliever, such as acetaminophen (Tylenol)
You may need surgery if your ear barotrauma is severe. A surgeon may rebuild the eardrum or the opening into the inner ear.
A tiny cut may be made in the eardrum, and in rare cases, a ventilation tube in the eardrum may be needed to equalize pressure between the middle ear and outside air.
If barotrauma is caused by allergies or respiratory infections, it will often be resolved when the underlying cause has been resolved. Mild to moderate cases take an average of up to two weeks for a full recovery.
Severe cases can take six to 12 months for a full recovery after surgery.
Preventing the ear barotrauma
Prevention is the best treatment for barotrauma. While incidences of barotrauma usually heal on their own, it is important to see a physician as severe cases can lead to permanent hearing loss.
Vertigo and hearing loss are symptoms that should be evaluated by a physician immediately.
Read More: Vertigo >
When flying, it is helpful for adults to eat, chew gum or suck on candy. This ensures that frequent swallowing occurs.
Infants and toddlers should suck on a pacifier, bottle, or sippy cup.
Special earplugs have been designed to help prevent barotrauma while flying. They are available over the counter and in many airports.
Unfortunately, these earplugs cannot be used while diving.