Dreading your next trip because you are one of the hundreds of fliers who suffer from pain in the ears the minute your flight takes off? Ear problems are surprisingly common among travellers on airplanes. While sometimes, they can be mildly annoying, at other times, there can be more serious effects, including acute pain in the ears, ear discharge and even temporary loss of hearing. However, fear not. Understanding why it happens as well as taking a few precautions can ensure that your journey is pleasant from take-off to landing!

Understanding blocked ears-

The Eustachian tube is a membrane-lined tube, about the thickness of a pencil lead, which connects the back of the nose to the ears. On one side (the ear), we have a space surrounded by bone and closed off from the outside world by the ear drum, and on the other side, a space that is open to the outside through the nose and mouth. The closed space in the ear is lined by a membrane which constantly absorbs air and this air is replaced from the Eustachian tube. Thus air pressure outside the ear drum and inside the space remains equal. When there is a difference in pressures, the ear feels blocked. This is because if the air in the middle ear is absorbed but not replaced, a vacuum forms which pulls the eardrum inwards, causing a block as it cannot vibrate. It is the stretching of the ear drum that causes pain.

This vacuum also pulls fluid into the space from the membrane, filling the middle ear with fluid. This can be dangerous as when the fluid builds up, it punctures the ear drum leading to discharge from the ear.

Common causes of Eustachian block-

Common cold, nasal allergies and infection in the tonsils or throat.

How does flying cause ear block-

When your flight takes off or lands, there is a rapid change in the air pressure. This causes swelling of the membranes, which does not allow the air pressure inside the ear to equalise rapidly, which in turn results in blocked Eustachian tubes and other ear problems.

How to unblock the tubes-

Swallowing unblocks the Eustachian tubes by activating muscles that open them. Chewing gum or sucking on hard candies helps this process. Yawning works better.

If yawning and swallowing both don’t work, pinch your nose shut, close the mouth and make sure you blow air into the nose from the mouth very gently.

If the pain and block persists, see a doctor immediately to get decongestant nasal drops and sprays to open the Eustachian tubes before fluid builds up in the ears. In rare cases, if the build-up of fluid in the ear is too much, the doctor may make a tiny puncture in the ear drum to release it. If the problem is recurrent, tiny plastic or metal tubes are inserted into the ear drum to equalise the pressure. These are called grommets—they fall out when the Eustachian tube function recovers.

For babies-

Sucking on a pacifier or feeding bottle during take-off or landing of the flight works. It is a good idea to feed the baby during the flight. Make sure you don’t allow the child to sleep during take-off and landing.

For people with chronic problems-

Nasal decongestant drops and sprays can be used to open the Eustachian tubes.

Tips for air travellers-

• If you have had ear surgery or are seeking treatment for any problem in your ears, ask your doctor if it’s okay for you to take a flight.
• If you are currently suffering from a severe cold, sinus infection, or an allergy attack, consider postponing your trip.
• Keep a decongestant pill or nose spray handy. Use it approximately an hour before descent to help the ears pop.
• Make sure you stay awake during take-off and descent.
• Carry chewing gum or a couple of hard candies that you can pop into your mouth during your flight.

Dr Dillon Dsouza , Consultant ENT and Head and Neck surgeon, Jaslok Hospital, Breach Candy Hospital and Desas Hospital