Air transport occurs at high altitude, usually around 10,000 meters. At higher altitudes, the air pressure decreases, which can cause ear problems. Inside the middle ear, the pressure is usually equal to the one of the outer ear. When the cabin pressure drops suddenly, a pressure difference is created between the middle ear and the outer ear. This blocks the Eustachian tube and can cause the sensation of plugged ear, an auditory discomfort called barotrauma. When this happens, the passenger may notice a strong pressure inside the ear and sometimes pain.
Earache in an aeroplane can occur especially during take-off or landing: you usually experience a 'plugged ear' sensation and sounds become muffled, you may also experience ringing or buzzing (tinnitus) and more or less intense pain. That sensation, which we commonly call 'plugged ears', is called barotrauma in medical terms.
The mechanism that creates earache is linked to the air pressure inside the aircraft cabin, which increases rapidly without the Eustachian tube, the small duct that connects the middle ear with the nose, being able to react efficiently to the sudden change in pressure. The consequence is a retraction of the tympanic membrane and consequent muffling and pain.
Under normal conditions, the pressure on both sides of the eardrum (the part towards the pinna corresponds to the external pressure and the part towards the middle ear corresponds to the air pressure inside the ear) is the same and this balance is maintained by the action of the Eustachian tube, which opens 3-4 times a minute (e.g. while yawning or swallowing), allowing air to pass through.
Sudden changes in atmospheric pressure can create an imbalance that causes an increase in pressure on the tympanic membrane. Hence the pain and other related symptoms.
The risk can be reduced with actions that facilitate the opening of the Eustachian tube, such as:
There are also many manoeuvres to perform that can be effective in compensating for internal pressure, such as:
Also effective is the use of the Otovent, a special balloon with a nasal nozzle that can be purchased in pharmacies. One inserts the nozzle into one nostril and, keeping the other nostril plugged, attempts to inflate the balloon. When the balloon is inflated like a large orange, one swallows with the mouth closed and nose plugged. In this way, the air inside the balloon, which has a certain pressure, opens the Eustachian tube and restores the internal pressure, which becomes equal to the external pressure. The operation is carried out from both sides, until the liberating pop is heard.
The same symptoms felt during flight can occur, although often in a milder form, when ascending or descending a mountain.
Yes, you can travel by plane when you have a cold. It is necessary to reiterate the concept that during a flight, your ears can become plugged due to pressure variations and this problem can be accentuated if you have a cold or nasal congestion. A cold causes swelling and mucus production in the airways, making it difficult for air to flow through the Eustachian tubes and regulate the pressure in the middle ear.
It is important to distinguish between plugged ears due to pressure changes and those related to a cold, which is a viral infection of the respiratory tract. If the ears remain plugged after flying or are accompanied by other symptoms, it is advisable to consult a doctor for an evaluation.
Children also get plugged ears during flights, especially if they are not breathing well because they have adenoids or are cold. To prevent discomfort and pain, it is important to try to keep them awake during take-off and landing. A sweet or a lollipop can encourage frequent swallowing. For toddlers, a dummy can be used or they can drink water or milk from a baby bottle.
It is a good idea to have your paediatrician recommend a decongestant nasal spray or ear drops: they can be very useful during the flight, especially if your child has cold or phlegm problems.
