Airplane ear is the stress exerted on your eardrum and other middle ear tissues when the air pressure in your middle ear and the air pressure in the environment are out of balance. You may experience airplane ear at the beginning of a flight when the airplane is climbing or at the end of a flight when the airplane is descending. These fast changes in altitude cause air pressure changes and can trigger airplane ear.
Airplane ear is also called ear barotrauma, barotitis media or aerotitis media.
Usually self-care steps — such as yawning, swallowing or chewing gum — can prevent or correct the differences in air pressure and improve airplane ear symptoms. However, a severe case of airplane ear may need to be treated by a doctor.
Airplane ear can occur in one or both ears. Airplane ear signs and symptoms may include:
If airplane ear is severe or lasts more than a few hours, you may experience:
Usually you can do things on your own to treat airplane ear. If discomfort, fullness or muffled hearing lasts more than a few hours or if you experience any severe signs or symptoms, call your doctor.
Airplane ear occurs when an imbalance in the air pressure in the middle ear and air pressure in the environment prevents your eardrum (tympanic membrane) from vibrating as it should. Air pressure regulation is the work of a narrow passage called the eustachian tube. One end is connected to the middle ear. The other end has a tiny opening where the back of the nasal cavity and the top of the throat meet (nasopharynx).
When an airplane climbs or descends, the air pressure in the environment changes rapidly, and your eustachian tube doesn’t react quickly enough. Swallowing or yawning activates muscles that open the eustachian tube and allow the middle ear to replenish its air supply, often eliminating the symptoms of airplane ear.
Ear barotrauma also may be caused by:
You may also experience a minor case of barotrauma while riding an elevator in a tall building or driving in the mountains.
Any condition that blocks the eustachian tube or limits its function can increase the risk of airplane ear. Common risk factors include:
Frequent or severe airplane ear may damage the tissues of the inner ear or eustachian tube, which increases your chances of experiencing the problem again.
Airplane ear usually isn’t serious and responds to self-care. Long-term complications may occur when the condition is serious or prolonged or if there’s damage to middle or inner ear structures.
If you experience severe pain or symptoms associated with airplane ear that don’t go away with self-care techniques, you’ll likely see your family doctor or a general practitioner first. You may, however, be referred to an ear, nose and throat specialist (ENT, or otolaryngologist). It’s useful to prepare for your appointment.
Preparing a list of questions will help you make the most of your time with your doctor. If you’re experiencing signs or symptoms of airplane ear, you might want to ask the following questions:
Don’t hesitate to ask your doctor any other questions you have.
Your doctor will ask you a number of questions, including:
To treat pain, you may take a nonsteroidal anti-inflammatory drug, such as ibuprofen (Advil, Motrin, others) or naproxen (Aleve, others), or an analgesic pain reliever, such as acetaminophen (Tylenol, others).
Your doctor will likely be able to make a diagnosis based on questions he or she asks and an examination of your ear with a lighted instrument (otoscope). Signs of airplane ear might include a slight outward or inward bulging of your eardrum. If your condition is more severe, your doctor may see a tear in the eardrum or a pooling of blood or other fluids behind your eardrum.
If you’re experiencing a spinning sensation (vertigo), there may be damage to structures of your inner ear. Your doctor may suggest a hearing test (audiometry) to determine how well you detect sounds and whether the source of hearing problems is in the inner ear.
For most people, airplane ear usually heals with time. When the symptoms persist, you may need treatments to equalize pressure and relieve symptoms.
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:
To ease discomfort, you may want to take a nonsteroidal anti-inflammatory drug, such as ibuprofen (Advil, Motrin, others) or naproxen (Aleve, others), or an analgesic pain reliever, such as acetaminophen (Tylenol, others).
With your drug treatment, your doctor will instruct you to use a self-care method called the Valsalva maneuver. To do this, you pinch your nostrils shut, close your mouth and gently force air into the back of your nose, as if you were blowing your nose. Once the medications have improved the function of the eustachian tubes, use of the Valsalva maneuver may force the tubes open.
Surgical treatment of airplane ear is rarely necessary. However, your doctor may make an incision in your eardrum (myringotomy) to equalize air pressure and drain fluids.
Severe injuries, such as a ruptured eardrum or ruptured membranes of the inner ear, usually will heal on their own. However, in rare cases, surgery may be needed to repair them.
Follow these tips to avoid airplane ear:
If you’re prone to severe airplane ear and must fly often, your doctor may surgically place tubes in your eardrums to aid fluid drainage, ventilate your middle ear, and equalize the pressure between your outer ear and middle ear.
These additional tips can help young children avoid airplane ear: