What Is Ear Barotrauma?
Aeroplane ear, or ear barotrauma, is a clogged-up, sometimes painful sensation that occurs when atmospheric pressure changes rapidly. It’s the most common health issue for people who fly. Additionally, it is frequently painful for infants and young children due to their still-developing ears.
Ear barotrauma can also occur when driving in the mountains, riding an elevator, or underwater. As a diver goes deeper, the rising water pressure outside the body squeezes the tympanic cavity behind the eardrum. Scuba divers refer to this as “ear squeeze.”
The middle ear, composed of the eardrum and bone, is an air-filled space connected to the back of the nose by a tunnel called the Eustachian tube. Outside air passes through the Eustachian tube to maintain balanced pressure within the tympanic cavity. Pain or ear squeeze can occur if the Eustachian tube malfunctions, creating a pressure difference across the eardrum.
Ear Barotrauma Symptoms
Common symptoms include:
- Stuffed feeling in your ears
- Hearing loss caused by the eardrum’s inability to vibrate and produce sound as it should
- Ear pain
When your Eustachian tubes open, you may hear a “pop” in your ears. If they remain blocked, your tympanic cavity may fill with clear liquid to balance the pressure. Blocked tubes can also prevent drainage, leading to severe symptoms such as:
- Extreme ear pain
- Vertigo (dizziness)
- Ruptured eardrum, causing blood or fluid leakage from the ear
- Hearing loss
Mild symptoms should resolve shortly after returning to normal atmospheric conditions. If symptoms persist or are severe, consult a doctor.
Ear Barotrauma Causes and Risk Factors
Your ears are sensitive to changes in air and water pressure, though most people don’t experience barotrauma. However, certain conditions can increase risk:
- Stuffy sinuses
- Colds or infections
- Allergies
- The shape and size of the auditory canal
- Tobacco smoke or irritants
- Hormonal changes, such as pregnancy
Additionally, exposure to loud explosions in the military or improper scuba diving gear can elevate the risk of ear barotrauma.
Ear Barotrauma Diagnosis
If you experience ear pain, your doctor will ask questions like:
- Did you have trouble clearing your ears?
- Did symptoms start during ascent or descent?
- How long did symptoms last?
- Do you have a history of ear or sinus infections?
Using an otoscope, your doctor will check for fluid behind your eardrum or damage to it. Damaged eardrums may take weeks to heal, potentially causing temporary hearing loss. Surgery may be needed if symptoms persist for over two months.
If you experience vertigo or spinning immediately after flying or diving, seek medical attention promptly.
Ear Barotrauma Treatment
Mild cases of ear barotrauma typically resolve within minutes. Prolonged symptoms may require treatment for infections or other complications. Severe damage, like a ruptured eardrum, can take months to heal and may necessitate surgery.
For mild cases:
- Try to “pop” your ears.
- Chew gum or candy.
- Drink water during flights, as swallowing keeps the Eustachian tubes open.
For divers, treatment begins during the dive. If you feel fullness or pain, don’t go deeper. Ascend slowly if ear-clearing techniques fail. If the eardrum ruptures, remain calm to avoid rapid ascent and ensure decompression stops.
Medical treatment options include:
- Nasal sprays and oral decongestants to open the Eustachian tube
- Antihistamines for allergy-related symptoms
- Pain medications and eardrops for non-ruptured eardrums
- Hearing tests if deafness or a ruptured eardrum is present
- Oral steroids for facial paralysis
Ear Barotrauma Prevention
To prevent ear barotrauma, keep your Eustachian tubes open:
- Medication: Use a decongestant, antihistamine, or nasal spray an hour before flying if you have allergies or a cold.
- Earplugs: Special aviation plugs can slow pressure changes, giving your ears time to adjust.
For divers:
- Equalize your ears before and during dives.
- Start with your feet down to ease balancing.
- Extend your neck to open the Eustachian tubes.
- Ascend slowly if in pain, and don’t dive with sinus or upper respiratory symptoms.
Summary
Ear barotrauma occurs due to rapid changes in pressure, often during flights, driving, or diving. While most cases are mild and resolve quickly, severe symptoms may require medical treatment or surgery. Preventative measures, such as equalizing pressure and using decongestants, can reduce the risk. Early diagnosis and proper management are crucial to prevent complications and ensure recovery.
