Airplane ear is the stress exerted on your eardrum and other middle ear tissues when the air pressure in your middle ear and the air pressure in the environment are out of balance. You may experience airplane ear at the beginning of a flight when the airplane is climbing or at the end of a flight when the airplane is descending. These fast changes in altitude cause air pressure changes and can trigger airplane ear.
Airplane ear is also called ear barotrauma, barotitis media or aerotitis media.
Usually self-care steps — such as yawning, swallowing or chewing gum — can prevent or correct the differences in air pressure and improve airplane ear symptoms. However, a severe case of airplane ear may need to be treated by a doctor.
Airplane ear can occur in one or both ears. Airplane ear signs and symptoms may include:
- Moderate discomfort or pain in your ear
- Feeling of fullness or stuffiness in your ear
- Muffled hearing or slight to moderate hearing loss
If airplane ear is severe or lasts more than a few hours, you may experience:
- Severe pain
- Pressure in your ear similar to being underwater
- Moderate to severe hearing loss
- Ringing in your ear (tinnitus)
- Spinning sensation (vertigo)
- Vomiting resulting from vertigo
- Bleeding from your ear
Airplane ear occurs when an imbalance in the air pressure in the middle ear and air pressure in the environment prevents your eardrum (tympanic membrane) from vibrating as it should. Air pressure regulation is the work of a narrow passage called the eustachian tube. One end is connected to the middle ear. The other end has a tiny opening where the back of the nasal cavity and the top of the throat meet (nasopharynx).
When an airplane climbs or descends, the air pressure in the environment changes rapidly, and your eustachian tube often doesn't react quickly enough. Swallowing or yawning activates muscles that open the eustachian tube and allow the middle ear to replenish its air supply, often eliminating the symptoms of airplane ear.
Ear barotrauma also may be caused by:
- Scuba diving
- Hyperbaric oxygen chambers
- Explosions nearby
You may also experience a minor case of barotrauma while riding an elevator in a tall building or driving in the mountains
Any condition that blocks the eustachian tube or limits its function can increase the risk of airplane ear. Common risk factors include:
- A small eustachian tube, especially in infants and toddlers
- The common cold
- Sinus infection
- Hay fever (allergic rhinitis)
- Middle ear infection (otitis media)
- Sleeping on an airplane during ascent and descent
Frequent or severe airplane ear may damage the tissues of the inner ear or eustachian tube, which increases your chances of experiencing the problem again.
Airplane ear usually isn't serious and responds to self-care. Long-term complications may occur when the condition is serious or prolonged or if there's damage to middle or inner ear structures.
Rare complications may include:
- Permanent hearing loss
- Ongoing (chronic) tinnitus
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