Air travel and ear pain: why it happens

Written by: Professor Owen Judd
Published: | Updated: 25/09/2019
Edited by: Laura Burgess

Do you ever experience pain, discomfort or temporary hearing loss in your ears during take-off or landing when you take a flight? This is actually a very common condition known as 'airplane ear' (or ear barotrauma), which happens because of the change in cabin air pressure.

Here, one of our top ENT surgeons Professor Owen Judd explains why some people may experience ear pain whilst flying and how it affects the ears exactly.

Is there such a thing as ‘airplane ear’?

Yes, these are the symptoms we get in our ears from pressure changes in an aeroplane cabin. It is very common. It is caused by normal pressure changes with regard to the Eustachian tube. The Eustachian tube is a narrow tube which runs from the back of the nose to the middle ear space, which is behind your eardrum.

The function of the Eustachian tube is to equalise the air pressure in the middle ear space and to keep the pressure in this space the same as in the air around us. This way the eardrum and tiny bones of hearing can move freely and conduct sound efficiently.

If the air pressure in the middle ear is not the same as outside, the drum and bones cannot move freely and this results in sound not conducting efficiently, which is perceived as a hearing loss.

On an aeroplane, the pressure in the cabin changes and this changes the pressure in our middle ear spaces. Typically this affects us during the rapid ascent and descent of the aeroplane when the cabin pressure rapidly changes and the Eustachian tube does not have sufficient time to equalise the pressure.
 

How can take-off and landing affect the ear?

At ground level, the atmospheric air pressure and the middle ear air pressure are the same and the Eustachian tube can cope with equalising relatively slow changes in pressure, such as driving up a steep hill or ascending in a lift/elevator.

During ascent in an aeroplane however, the pressure in the cabin drops far more rapidly and therefore the middle ear pressure is high by comparison. This causes the eardrum to bulge outwards and causes a pressure feeling and brief discomfort.

During descent the reverse happens and the middle ear pressure is lower than the cabin pressure, causing the eardrum to get sucked inwards also causing discomfort. The pressure difference will prevent the eardrum from vibrating normally and so can also result in a muffled blocked sensation in the ear and a sensation of hearing loss. As the Eustachian tube acts to equalise these pressure changes the eardrum will snap back to its usual position with a “pop” and symptoms of pressure or muffled hearing loss will resolve.
 

Why do some people – who normally have no ear pain – experience it when flying?

If our Eustachian tubes are working completely normally and efficiently, we can “pop” our ears and equalise the pressure. If we have Eustachian tube dysfunction (ETD) however, we find it very difficult to equalise the pressure and the pressure difference can lead to pain as the eardrum is stretched. In some cases, this can become quite severe.

ETD is a common condition caused by swelling or obstruction of the tube as it opens in the back of the nose. This can happen naturally following a cold or viral infection, sinusitis or allergy affecting the nose.

It is more common in smokers due to thickening of mucus, and in younger children due to the slightly different shape and length of the tube as they grow.
 

What can I do to relieve ear pain when I am on my flight?

Anything we can do to encourage the normal function of the Eustachian tube can help. The Eustachian tube is opened by action of tiny muscles attached to our jaw, palate and throat, therefore anything that helps to move these muscles helps to open the tube and equalise middle ear pressure.

Chewing, swallowing, yawning or simple stretching exercises, opening and closing the jaw can help. Sucking a sweet can help, and in babies sucking on a bottle during take-off and landing can prevent pain.

In those with ETD, this may not be sufficient and so more active exercises and medication can assist. This includes the use of a Valsalva manoeuvre. In this exercise, we take a deep breath and then pinch the nose and blow out the cheeks under pressure. This forces the air up the Eustachian tube into the middle ear and helps to equalise the pressure during landing.

Nasal sprays of saline or decongestants, or oral decongestant medicine or tablets that are taken 30 minutes before take-off or landing can also help.


Book an appointment today with Professor Judd if you’re suffering from any unusual ear-related symptoms.

By Professor Owen Judd
Otolaryngology / ENT

Professor Owen Judd is a highly-trained consultant ENT surgeon with a special interest in laryngology (voice disorders) and neurotology (disorders of the brain and ear, especially balance, dizziness and facial paralysis). Practising across clinics in Derby and Nottingham, Professor Judd provides the full range of ENT surgical procedures as well as a comprehensive paediatric service. He has particular expertise in complex ear surgery

He has particular expertise in migraine, balance disorders, and complex ear surgery, and was one of the first surgeons in the country to offer total endoscopic ear surgery - a minimally invasive ear surgery technique. He now teaches this technique nationally. He has also introduced minimally invasive laryngeal surgery under local anaesthetic for voice problems, to the Midlands region.

Originally qualifying from the University of Nottingham, Professor Judd completed his higher surgical training in London, Plymouth, Southampton and the East Midlands. He undertook a specialist Fellowship in Neurotology and Otological implantation at Queen’s Medical Centre in Nottingham and was appointed Consultant Neurotologist and Laryngologist ENT Surgeon at the Royal Derby Hospital in 2014. He has a prestigious BMJ Visiting Professorship in Balance Medicine, being a regular international speaker on vertigo and dizziness. He is also Honorary Associate Professor at the University of Nottingham and Associate Clinical Sub-Dean for the University Medical School. He is actively involved in all areas of ENT research and has published over 60 articles in peer-reviewed journals, 6 book chapters, and 2 textbooks to date.

Professor Judd is also highly experienced in facial rejuvenation without the use of surgery. He has successfully treated over 3,000 patients with a range of injectable treatments and is a pioneer of the TimeNet procedure, which is designed to stimulate collagen production over a longer period of time. Professor Judd can also provide minimally-invasive earlobe surgery and treat patients experiencing hyperhidrosis (excessive sweating).

View Profile

Overall assessment of their patients


  • Related procedures
  • Facelift
    Neck lift
    Otoplasty
    Thread lift
    Buttock lift
    Botulinum toxin (Botox™)
    Dermal fillers
    Facial reconstruction
    Congenital malformations
    Facial plastic surgery
    This website uses our own and third-party Cookies to compile information with the aim of improving our services, to show you advertising related to your preferences as well analysing your browsing habits. You can change your settings HERE.