Some of us experience discomfort or pain in our ears during flying. It happens mainly during ascent and descent, or if the altitude changes suddenly. It almost feels like the ear is blocked and we cannot hear properly. This phenomenon is commonly called ‘Airplane Ear’.
‘Airplane Ear’ is very common. It is usually quite moderate and fixes itself in many cases. However, it may turn severe and the pain may get worse. The pressure in the ears may resemble that of an underwater diver. Furthermore, you may experience moderate to severe hearing loss, ringing in your ear (tinnitus) or spinning sensation (vertigo). The ears may also bleed in extreme cases.
Why does it happen?
This happens because a rapid change in air pressure stretches the eardrum, suddenly.
We need to understand two aspects here. First, the structure of the ear and second, what happens to the air pressure during ascent and descent.
If we look at the structure of the ear, below, we can see a narrow passage in the inner ear called the Eustachian tube that regulates the air pressure. What we cannot see in the illustration is that this tube is connected to the nasopharynx which is a small opening where the throat and the nasal passage meet. The ear, nose, and throat are therefore connected exactly there. When the surrounding air pressure is normal, mostly on land, the tympanic membrane or the eardrum behaves normally and responds to sound and airwaves accordingly.
Air pressure and how it affects the ear
A rapid change in altitude creates an instant difference in air pressure between inside and outside the ear. When your flight takes off and the plane begins to ascend, the air pressure inside the inner ear quickly becomes greater than the outside air pressure. The eardrum then swells outward. Imagine a cake rising inside the oven while baking. This causes discomfort and you feel that your ear is ‘blocked’.
The opposite happens while landing. The pressure inside the inner ear rapidly becomes less than outside and the eardrum goes inward. Imagine a vacuum pulling in all the air that causes stretching of the eardrum and flattening of the Eustachian tube. This results in extreme discomfort and also pain.
Often, a quick swallowing or yawning action alleviates the symptoms because it allows the Eustachian tube to open up and restore the air pressure to normal levels. We feel that the ear has just ‘popped’.
Sometimes it is not that easy. It becomes more painful during descent if you have any other condition like congestion of the nose or swelling due to infection. The air gets trapped in the area behind the eardrum putting pressure on it giving rise to excruciating pain.
What can you do?
If you have any questions, you're welcome to contact us for more details at the Tinnitus & Hearing Center of Arizona at (480) 831-6159.
Dr. Rohe is a nationally-recognized audiologist specializing in Tinnitus Therapy and other hearing conditions.