Have you ever experienced a blocked ear, especially while flying, diving, or driving through a mountain pass? This sensation can be quite uncomfortable and is often caused by changes in pressure that affect our ears, an area that is particularly sensitive.
Dr. Jennifer Cueva, a specialist in Otolaryngology and Voice Pathology for both children and adults, explains that the Eustachian tube, a tube-like structure, connects the middle ear with the back of the nose. This tube regulates air pressure within the middle ear. When there is a sudden change in atmospheric pressure, the Eustachian tube may not be able to react quickly enough to equalize the pressure between the middle ear and the external environment. This can lead to a condition known as barotrauma, which is damage caused by changes in barometric pressure, either in the air or in water.
The risk of barotrauma can occur in any situation involving sudden atmospheric pressure changes, such as during flights, diving, hyperbaric chamber use, or even near an explosion. Additionally, less severe cases can happen while driving through mountain passes or during elevator rides.
If you experience symptoms indicative of barotrauma, Dr. Cueva points out that the most common signs include a feeling of ear blockage, which often improves with swallowing or yawning, and a sense of pressure in the ears. People might also hear continuous or intermittent sounds, such as ringing or buzzing, or feel as if they have fluid inside their ears.
For those wondering about who might be more susceptible to these issues, Dr. Cueva notes that any condition that causes increased blockage of the Eustachian tube—the tube being smaller and more horizontal in infants and small children—can heighten the risk of barotrauma. Common colds, sinusitis, rhinitis, or otitis media can also contribute to this risk. Therefore, she advises against flying if you are experiencing severe colds, nasal congestion, sinusitis, otitis, or have recently undergone nasal or ear surgery.
To prevent barotrauma, several strategies can help mitigate the discomfort. It’s recommended to yawn and swallow during ascents and descents, as this action activates the muscles that open the Eustachian tubes. Additionally, using the Valsalva maneuver—pinching your nose and blowing while keeping your mouth closed—can force air into the ear. Chewing gum or sucking on candy can also be effective preventative measures.
Other options include using a nasal decongestant spray about half an hour before takeoff, during the flight, and again before descent. However, these sprays should not be used for extended periods. Oral decongestants can help during specific moments or for those with a history of barotrauma, but users should check for contraindications, especially in cases of glaucoma or heart conditions, and during pregnancy. Filtered earplugs that allow for gradual pressure equalization during takeoff and landing may also be beneficial.
In extreme cases where there is a high risk of barotrauma, a small surgical procedure to insert drainage tubes may be recommended to equalize pressure between the outer and middle ear.
While the sensation from barotrauma often resolves on its own, it can sometimes persist for days. Should this happen, it’s important to see a specialist to avert potential complications that can arise from pressure changes. Generally, these traumas are mild, causing ear blockage, pressure, tinnitus, temporary ear pain, or hearing loss. However, in severe cases, symptoms may escalate to include middle ear bleeding, eardrum perforation, intense vertigo, or even facial paralysis.
Barotrauma can affect children more severely, as their Eustachian tubes are shorter and positioned more horizontally, making it harder for them to drain properly and increasing the risk of infection. Dr. Reyes Márquez, an otolaryngologist, indicates that children could naturally cry during landing to encourage airflow into their ears. To minimize discomfort, using a bottle or pacifier during takeoff and landing can assist them, though it’s best if babies stay awake during these times. If a child has an ear infection, flying is not advisable.
To learn more about how to relieve ear ringing, check out this article: 7 exercises and remedies to relieve ear ringing.
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