Have you experienced that nagging or intense pain during take off which settled down over the course of flight only to come back with vengeance during landing?
What is airplane ear?
Pain or discomfort during the course of air travel is called airplane ear.
It is also seen during other pressure changing events like going deep underground or taking a really swift elevator ride or during deep sea diving.
Why does it happen?
Think of our middle ear as an airtight jar with a single valve, the air trapped inside allows for excellent conduction of sound and exchange of gases like oxygen to keep the structure functioning at its optimal level. Every now and then the valve ever so gently keeps releasing the excess gases or pump in a little more air.
Where does the valve get the air from?
Our body’s finest humidifier and air purifier is our nose, nose along with our para nasal sinuses filters and humidifies all the air our body needs and then processes it to our lungs to filter out the oxygen from the rest of the air. In this whole process the nose delivers some of the air into a long tortuous tube which opens into the ear.
The valve in the nose is pressure sensitive when it detects pressure changes in our ears it starts to open and close to maintain pristine sound conduction and allows for proper gaseous exchange in the ear.
Other bodily functions which effect the functioning of the valve
The location of the valve as explained is in the nose, but to be more accurate that is also at the junction between nose and throat. Constriction of the pharyngeal ie, Throat muscles can force the valve to open and close.
That is why swallowing, chewing or yawning might give some release.
Should I pop my ears while air travel?
Popping of the ears while experiencing slight blockage may sometimes alleviate the symptoms for a while it can also be dangerous or cause extreme pain or cause rupture of the eardrum.
Now that we have an understanding that the faulty line is originating from the nose we will have to assess why the blockage is happening.
If you have a stuffy nose that is filled with mucous it will lead to the mucous getting forced into the pipe and end up inside the ear, which isn’t a good outcome. The fluid inside the ear will further dampen the hearing and cause pathologies inside the ear.
Precautions to take
- Do not travel when you have a stuffy nose.
- Try relieving the pressure slowly by swallowing or gently sucking on a hard piece of candy.
- Chewing on gum to get the muscles to stretch and relax.
- Carry a decongestant or saline nasal drops to irrigate the nose or move along any retained mucus.
Treatment
Air plane ear or serous otitis media is an acute condition and will require immediate attention to avoid long term problems like
Glue ear
Atelectasis
Perforation and chronic suppurative otitis media
Conductive deafness, visit ENT clinic
Medical management
Drugs are the first line of management, taking all your medical history into consideration antibiotics, anti histamines, decongestants some cases mild doses of steroids are given to the patient
Interventional management
In cases that are refractory to medical management or severe cases, ent doctors might either drain the fluid from the middle ear by puncturing the ear drum. In this procedure they might leave behind a two way valve on the ear drum.
Points to note
The treatment for each patient is carefully decided taking into consideration both the status of the nose and ear.
Understanding the problem originates in the nose any procedure done in the ear is like fixing a leaking roof with a bucket, it might hold for a while but ultimately fester until you fix the leaky pipe.
