Earache on the plane and when diving

Earache during a flight or diving is a disorder caused by a difference in pressure between the internal structures of the ear and the external environment.

It is important to know what the reason is and what to do to avoid damage to the hearing aid.

Development of earache on the plane or when diving (pathophysiology)

The middle ear is a cavity found inside the temporal bone.
The functions are:

  • amplification of sound waves,
  • Transmission of these vibrations to the inner ear.

The outer part is delimited by the tympanic membrane, a circular structure with a depression in the middle.
The eardrum is connected to a chain of three ossicles: hammer, anvil and stirrups.
At the end of the chain is an eardrum-like membrane called an oval window.
Under physiological circumstances, the middle ear contains air.
There is a connection between the structures of the oropharynx (this is the central area of the throat) and the middle ear: the Eustachian tube.
The Eustachian tube is a stationary virtual channel (closed) that opens in different situations, namely:

  • Swallow
  • Chew
  • Yawn.

If you close your nose and blow against it, air enters the channel under pressure increase.
All these situations allow the passage of air from the oral cavity to the middle ear, therefore, under physiological conditions, the pressure in the middle ear corresponds to atmospheric pressure.

There are situations when an imbalance is formed between the pressure in the middle ear and the atmospheric pressure.
For example, during:

  1. A flight in an airplane,
  2. To fast diving.

The result is discomfort or earache.

When flying in an airplane:

  1. The external atmospheric pressure decreases,
  2. The internal pressure remains constant.

The internal pressure presses on the eardrum and causes a displacement of the middle part to the outside.

The consequences are:

  1. The membrane loses its elasticity,
  2. The patient suffers a hearing loss.

There is activation of mechanoreceptors (sensitive receptors) and, in severe cases, nociceptors (nerve endings that transmit pain signals), so the patient feels pain and discomfort.

Conversely, if sinking too quickly, the opposite situation arises.

There are diseases that cause the occlusion of the Eustachian tube, such as:

Earache when flying

Barotraumatic ear infection is characterized by earache or an injury to the tympanic membrane and is caused by the increase or decrease in ambient pressure.Some people experience ear pain when flying or diving due to a difference in pressure between the middle ear and the surrounding area.

Causes can be:

  • Poor functioning of the Eustachian tube; if the Eustachian tube does not function correctly, a negative pressure develops in the middle ear, which causes pain when flying by plane (especially when landing) and when diving.
  • Upper respiratory tract infections and otitis media. In these cases, the mucous membrane in the paranasal sinuses and Eustachian tube swells. The result is a reduction in air circulation and problems in compensating for pressure fluctuations, which causes earache.

Symptoms of barotraumatic ear infection include:

Complications include perforated tympanic membrane, which is a violation of the membrane located between the middle and outer ear.

Therapy, prevention and remedies for pain during flying

The symptoms of barotrauma on the ear disappear when the pressure in the ear is the same as the atmospheric. Air enters and exits through the middle ear and Eustachian tube, so it is important that these structures are free and functional.

Here is a list of remedies to prevent barotraumatic otitis with its relative symptoms.

  • Patients with a middle ear infectionsinusitisallergy or headache should avoid a flight and cure the disease first.
  • If it is not possible to postpone the flight, the use of decongestant drops or a nasal spray will partially reduce or alleviate the symptoms: so you should use the decongestant before the flight.
  • Valsalva experiment: This method simplifies the passage of air through the Eustachian tube. To do this, you have to hold your nose, keep your mouth closed and blow against it.
  • Breathing or yawning with your mouth open, the movement of the mouth can help balance the pressure and relieve the discomfort in the ears.
  • Chewing a gum during takeoff and landing helps keep the Eustachian tube open.
  • Swallowing helps to keep the Eustachian tube open, it is best to suck a candy during the flight.

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