Materiały źródłowe

• #1 “Airplane ear”—A neglected yet preventable problem

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6779601/

  Airplane ear is also known as ear barotrauma, barotitis media or aerotitis media. […] Generally, airplane ear occurs due to quick changes in altitude and quick changes in air pressure. […] However, the eustachian tube dysfunction may occur with any changes in pressure and failure to ventilate through the middle ear space. This may result in outward bulging of the tympanic membrane causing moderate to severe earache. […] Conversely, due to the vacuum effect, if the air pressure inside the middle ear space reduces rapidly compared to the external ear pressure, the tympanic membrane may be pulled inside due to the pressure gradient. […] The pathophysiology remains the same in cases of scuba diving, in hyperbaric oxygen chambers, and during explosions happening nearby. […] The common risk factors for airplane ear include small eustachian tube (infants and toddlers), common cold, acute or chronic sinusitis, allergic rhinitis, otitis media, and napping on an airplane during rapid pressure change in our middle ear.

• #2 Middle-ear pain and trauma during air travel

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4298289/

  These two complications are called barotrauma and are uncommon given the many plane flights each year. […] Both of these problems can result in a balance problem with unsteadiness. […] However, vertigo, with a prolonged sense of unreal movement (which is usually rotary), is very rare and suggests some disruption of the inner ear with a possible perilymph leak. […] The factors predisposing to barotrauma include the quality of cabin pressurisation and the speed of descent (short haul flights are worse in general), the individuals anatomy and Eustachian tube function, the state of the respiratory mucosa at the time of the flight (with inflammation from colds, allergies, or sensitivities), and being awake or asleep (asleep is worse because the individual swallows much less). […] Experience in military aviation shows that most perforations will heal spontaneously in adults.

• #3 Video: Ear Pressure-Merck Manual Consumer Version

  https://www.merckmanuals.com/home/multimedia/video/ear-pressure

  The middle ear is an air-filled chamber that is connected to the nose and throat via a channel called the eustachian tube. […] Normally, air moves through this tube to equalize the pressure in the middle ear with that of the air around us. […] This is especially important when there are large changes in the external air pressure, such as in flying or scuba diving. […] For example, as an airplane rises in altitude, the air pressure in the cabin gradually drops. […] This causes the pressure in the middle ear to seem relatively high, and the eardrum bulges slightly outward. […] When the pressure difference between the cabin and the middle ear reaches about 15 millimeters of mercury (mm Hg), the eustachian tubes open with a popping sensation and air is released from the middle ears. […] Under normal circumstances, this happens about once every five hundred to one-thousand feet during ascent.

• #4 Middle-ear pain and trauma during air travel

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4298289/

  Changes in air pressure during flying can cause ear-drum pain and perforation, vertigo, and hearing loss. […] It has been estimated that 10% of adults and 22% of children might have changes to the ear drum after a flight, although perforation is rare. […] Symptoms usually resolve spontaneously. […] The normal middle ear and mastoid is filled with air at atmospheric pressure, and the tympanic membrane (eardrum) is most efficient at absorbing sound when the air pressures are the same both sides (i.e., the membrane is not stretched). […] During ascent in an aeroplane flight, the external pressure drops and it is relatively easy for air to escape from the middle ear down its pressure gradient into the nasopharynx. […] As the plane starts to descend, the external pressure increases and the Eustachian tube has to open to allow the relatively low middle ear pressures to equalise.

• #5 Ear Barotrauma (Airplane Ear): Symptoms and Treatment

  https://my.clevelandclinic.org/health/diseases/17929-airplane-ear

  Ear barotrauma refers to damage to your ears that can happen if there’s a sudden change in air pressure or water pressure that affects your middle ear. […] Ear barotrauma happens when air or water pressure suddenly changes, putting pressure on your eustachian tubes. Your eustachian tubes run from the back of your middle ear to the back of your throat. The tubes help maintain equal air pressure on both sides of your eardrum by letting outside air into your middle ear. […] Air pressure changes when airplanes take off and land. That change happens faster than your eustachian tubes can react. The same thing happens if you do deep-water diving, as water pressure quickly changes. Ear barotrauma can happen more frequently if you have congestion from a cold or allergies. Congestion may block or inflame your eustachian tubes, making it even harder for them to manage air pressure changes. […] Ear barotrauma (airplane ear) is the most common form of barotrauma. Barotrauma happens when there’s a sudden change in air and/or water pressure.

• #6 Airplane ear | Beacon Health System

  https://www.beaconhealthsystem.org/library/diseases-and-conditions/airplane-ear?content_id=CON-20164012

  Airplane ear happens when the air pressure in the middle ear and the air pressure outside the ear aren’t equal. This can happen in an airplane that is climbing or going lower. A narrow passage called the eustachian tube keeps air pressure in the ear stable. When a plane climbs or goes lower, the air pressure changes quickly. The eustachian tube often doesn’t react quickly enough. This can cause airplane ear. […] Airplane ear happens when the air pressure in the middle ear and the air pressure inside the airplane don’t match. The mismatch keeps the eardrum, also called the tympanic membrane, from moving as usual. […] When an airplane climbs or goes lower, the air pressure changes fast. The eustachian tube often can’t react fast enough. That causes the symptoms of airplane ear.

• #7 Video: Ear Pressure-Merck Manual Consumer Version

  https://www.merckmanuals.com/home/multimedia/video/ear-pressure

  Conversely, as the plane descends and the pressure in the cabin increases, the middle ear pressure seems relatively low and the eardrum is pulled slightly inward. […] Now when the eustachian tubes open, air rushes into the middle ears to equalize the pressure. […] Sometimes during descent a manual technique must be used to equalize middle ear pressure. […] Illnesses such as colds and ear infections can cause the membranes surrounding the eustachian tubes to swell. […] This may make pressure equalization more difficult, producing pain in the middle ear. […] Caution should be taken to avoid flying or scuba diving when one of these conditions is present, which may affect the middle ear.

• #8 Airplane Ear: Why It Happens and How to Prevent It | Ear & Sinus Institute

  https://earandsinusinstitute.com/airplane-ear-why-it-happens-and-how-to-prevent-it/

  Airplane ear occurs when the air pressure in the middle ear differs from the air pressure outside the body. The Eustachian tube, which connects the middle ear to the back of the nose and throat, is responsible for regulating ear pressure. Rapid changes in altitude, especially during a flights ascent or descent, can make it difficult for the Eustachian tube to adjust, causing discomfort. […] Airplane ear occurs due to rapid changes in cabin pressure during takeoff and landing. As the plane ascends or descends, the Eustachian tube, which helps regulate pressure in the middle ear, may struggle to equalize it with the external environment. This imbalance creates a vacuum effect, either pulling the eardrum inward or pushing it outward, leading to discomfort and pain. […] Certain individuals are more prone to airplane ear due to difficulties in equalizing pressure. Factors such as nasal congestion from colds, sinus infections, or allergies can block the Eustachian tube. Eustachian tube dysfunction can also contribute to the issue. Additionally, young children who have narrower Eustachian tubes often experience more trouble adjusting to pressure changes.

• #9 Ear – blocked at high altitudes: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/002077.htm

  The air pressure outside of your body changes as altitude changes. This creates a difference in pressure on the two sides of the eardrum. You may feel pressure and blockage in the ears as a result. […] The eustachian tube is a connection between the middle ear (the space behind the eardrum) and the back of the nose and upper throat. This structure connects the middle ear space to the outside world. […] Swallowing or yawning opens the eustachian tube and allows air to flow into or out of the middle ear. This helps equalize pressure on either side of the eardrum. […] If your ears are blocked, you can try breathing in, then gently breathing out while holding your nostrils and mouth closed. Use care when doing this. If you breathe out too forcefully, you can cause ear infections by forcing bacteria into your ear canals. You can also create a hole (perforation) in your eardrum if you blow too hard.

• #10 Otic Barotrauma – Ear, Nose, and Throat Disorders – MSD Manual Professional Edition

  https://www.msdmanuals.com/professional/ear-nose-and-throat-disorders/middle-ear-and-tympanic-membrane-disorders/otic-barotrauma

  Otic barotrauma is ear pain or damage to the tympanic membrane caused by rapid changes in environmental pressure. […] To maintain equal pressure on both sides of the tympanic membrane, gas must move freely between the nasopharynx and middle ear. When an upper respiratory infection, allergy, or other mechanism interferes with eustachian tube function during changes in environmental pressure, the pressure in the middle ear either falls below ambient pressure, causing retraction of the tympanic membrane, or rises above it, causing bulging. […] A very large pressure differential may cause bleeding into the middle ear, tympanic membrane rupture, and the development of a perilymph fistula through the oval or round window of the inner ear. […] Symptoms usually worsen during a rapid increase in external environmental pressure, such as a rapid ascent (eg, during scuba diving) or descent (eg, during air travel or sky diving). Sensorineural hearing loss or vertigo during descent suggests the development of a perilymph fistula; the same symptoms during ascent from a deep-sea dive can suggest an air bubble formation in the inner ear.

• #11 Stanford Otology and Neurotology | Otolaryngology⁠ — Head & Neck Surgery | Stanford Medicine

  https://med.stanford.edu/ohns/OHNS-healthcare/earinstitute/conditions-and-services/conditions/eustachian-tube-dysfunction.html

  Individuals with Eustachian tube problems may experience difficulty equalizing their middle ear pressure when flying. […] During airplane travel the ears are subject to large swings in barometric pressure. […] Pressure equalization during descent is much more difficult. […] Most adults can fly without difficulty unless they have an illness that has temporarily swollen the lining of the Eustachian tube and narrowed its passageway. […] Some adults have very mild Eustachian tube dysfunction and only have symptoms when flying.

• #12 Middle ear barotrauma – Wikipedia

  https://en.wikipedia.org/wiki/Middle_ear_barotrauma

  Middle ear barotrauma occurs when a pressure difference develops over the eardrum, causing bulging towards the low pressure side, stretching the tissues which in a severe case can rupture, which immediately equalises the pressure and removes the stretching forces, but leaves local trauma. […] Increased pressure difference will cause blood vessels to rupture, which may bleed into or inside of the membrane. […] In divers this usually occurs during descent, when the ambient pressure rises due to increasing hydrostatic pressure. […] If the diver does not equalise sufficiently a pressure difference may develop that is large enough to damage the eardrum as described. During ascent, the converse occurs, with the internal pressure higher than external. […] The pressure difference required to rupture the eardrum is thought to be approximately 100 kPA (1 bar or 10 msw).

• #13 Middle-ear pain and trauma during air travel

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4298289/

  The increasing external pressure causes the eardrum to be stretched inwards, but the strength and elastic properties of the normal eardrum may be enough to physically withstand this pressure difference although pain develops. […] Occasionally, there comes a point called the 'critical closing pressure’, when the tube cannot open and the pressure differential in the middle ear increases to the extent that changes occur. […] The fluid is an exudate or blood or both. […] Thus, the middle ear fills to a greater or lesser extent with fluid and the pressure on the membrane is relieved (Boyle’s Law: P1V1 = P2V2). […] The alternative is that, in a membrane with a healed perforation, the thin scar gives way and a new perforation develops, thereby instantly overcoming the pressure differential but again leaving some hearing loss and possibly an additional blood-stained discharge.

• #14 Content – Health Encyclopedia – University of Rochester Medical Center

  https://www.urmc.rochester.edu/encyclopedia/content?contenttypeid=85&contentid=P00473

  When traveling by air, many people feel discomfort in their ears as the altitude changes. This is 1 of the most common health complaints of airplane passengers. It is caused by a difference in air pressure within the middle ear versus in the environment. The changing altitude as the plane takes off or lands can cause symptoms such as ear fullness, muffled hearing, and pain that may range from mild to severe in the ears. […] Ears that are already blocked (by a cold, for example) can’t equalize the air pressure in the middle ear enough. This creates a vacuum that sucks the eardrum in and stretches it. When the eardrum can’t vibrate, the sound is muffled. The stretched eardrum can be very painful. […] If swallowing or yawning does not ease the ears, try this ear-clearing method: […] If you hear a pop, your ears are unblocked. You may need to repeat this process a few times, especially during the plane’s descent before landing. After landing, if your ears don’t open and are still painful, see a healthcare provider who specializes in ear problems.

• #15 Airplane ear: Causes and Treatment | Psychlinks Forum — Archive Only (2004-2022)

  https://forum.psychlinks.ca/threads/airplane-ear-causes-and-treatment.10835/

  When air pressure on one side of your eardrum is out of balance with that on the other side, a number of things can happen in the middle ear, depending on the severity and duration of the pressure difference. […] If the air pressure imbalance persists, fluids from the middle ear tissues may fill the space in an attempt to equalize the pressure. […] If the pressure is severe or prolonged, the eardrum may rupture. […] 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 is damage to middle or inner ear structures. […] Your doctor may prescribe medications or direct you to take over-the-counter medications to control conditions that may prevent the eustachian tubes from functioning well. […] Surgical treatment of airplane ear is rarely necessary. However, your doctor may make an incision in your eardrum (myringotomy) to equalize air pressure and drain fluids.

• #16 How to stop ears from popping on a plane​?

  https://www.amplifon.com/uk/audiology-magazine/airplane-ear-problems

  When you have otitis media, it is inadvisable to travel by air because during take-off and landing, the pressure inside the aircraft cabin changes rapidly. Usually, it is possible to balance the pressure by yawning or swallowing. However, if the Eustachian tube is obstructed, these methods are ineffective. Even after recovery, it is advisable to undergo a medical examination to check the integrity of the eardrum. […] A cold causes swelling and mucus production in the airways, making it difficult for air to flow through the Eustachian tubes and regulate the pressure in the middle ear.

• #17 Content – Health Encyclopedia – University of Rochester Medical Center

  https://www.urmc.rochester.edu/encyclopedia/content?contenttypeid=85&contentid=P00473

  Small children are more likely to have blocked ear canals. That’s because their eustachian tubes are narrower. Using a bottle or pacifier during take-off and landing may help pop their ears. Try to keep small children awake during a descent so they will swallow more often. Children age 4 or older may chew on gum.

• #18 How to Pop Your Ears on a Plane: 9 Tricks for Relieving Ear Pressure, According to Medical Experts | Condé Nast Traveler

  https://www.cntraveler.com/story/how-to-pop-ears-after-flight

  Colds or allergies, which trigger inflammation in mucus membranes, are often to blame when ears dont clear easily. […] That inflammation then causes the Eustachian tube to become clogged, inhibiting it from opening and closing properly. […] If you suffer from pressure-related ear pain during every takeoff and landing (whether you have a cold or not), Eustachian tube dysfunction could be the underlying issue. […] This condition is diagnosed in 1% of the adult population, while approximately 70% of children develop it before age 7, according to the Cleveland Clinic. […] Frequent travelers with Eustachian tube dysfunction might want to consider having pressure equalization tubes implants in their ears. […] This simple, 15-minute procedure, which is performed under anesthesia, helps your ears drain fluid and regulate pressure.

• #19 Airplane Ear: Causes, Symptoms, and Treatments | SELF

  https://www.self.com/story/understanding-airplane-ear?hootPostID=3796e69d3b4a6f188d0f558381d07f81

  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. […] 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. […] 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. […] 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.

• #20 Airplane ear: How to avoid ear pain and popping during flight

  https://www.healthyhearing.com/report/52447-Airplanes-and-ear-pain-why-it-happens-and-what-you-can-do

  Many people experience symptoms like ear pain, clogged ears, and muffled hearing when flying, especially during takeoff and landing. […] Airplane ear is usually a minor annoyance that resolves on its own. However, it’s important to see a doctor if your symptoms are severe or last for several days post-flight. […] Ear pain from flying happens when there is a change in altitude and your ears have trouble equalizing. […] The pressure inside the inner ear and the air pressure outside dont have time to equalize. This is known medically as ear barotrauma. […] The tympanic membrane or eardrum swells outward. […] Conversely, if air pressure inside the inner ear rapidly becomes less than the air pressure outside, the tympanic membrane will be sucked inward, almost like a vacuum effect. […] Whether ascending or descending, the stretching of the eardrum can cause pain.

• #21 Barotrauma of the Ear – Ear, Nose, and Throat Disorders – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/ear-nose-and-throat-disorders/middle-ear-disorders/barotrauma-of-the-ear

  The pressure difference can cause pain and can bruise or rupture the eardrum. […] If outside pressure is increasing, as in a plane descending or a diver going deeper underwater, the person should pinch the nose shut, hold the mouth closed, and try to blow gently out through the nose. This maneuver forces air through the blocked eustachian tube. […] If people have a perilymph fistula, surgery may be necessary to close the fistula and stop the leak.

• #22 Aeroplane Ear: Symptoms, Causes, and Treatment

  https://patient.info/travel-and-vaccinations/health-advice-for-travel-abroad/ears-and-flying

  Aeroplane ear, or the feeling of blocked or painful ears while flying, is caused by pressure changes. […] The pain is caused by unequal pressure that develops between the air in the middle ear and the air outside the ear during takeoff and landing. […] Air pressure is highest nearer the ground. So as a plane descends, the air pressure becomes higher. This pushes the eardrum inwards which can be painful. To relieve this, the pressure in the middle ear has to rise quickly too. Air needs to travel up the Eustachian tube into the middle ear to equalise the pressure. […] Aeroplane ear is a mild and temporary form of ear barotrauma. […] Complications are extremely unusual, or millions of people wouldn’t be flying on a regular basis. Very occasionally, the eardrum can be put under so much pressure that it bursts (perforates), leaving a hole in the eardrum. If this does happen, the pain usually goes away immediately. Perforated eardrums usually heal well without any treatment. […] It is advisable NOT to fly if you have an ear infection, such as otitis media or otitis externa. If you do fly, the pain in your ear may be worse and it may take longer to settle. You may be more likely to have a perforated eardrum.

• #23 Chapter 2: Injuries – Divers Alert Network

  https://dan.org/health-medicine/health-resource/dive-medical-reference-books/ears-diving/ear-injuries/

  The Valsalva maneuver increases the pressures in cranial tissues and circulation, which may transmit to the cochlear fluid, causing an outward movement of the round window. […] Leakage of perilymph from the labyrinth may occur when the round or oval window is disrupted due to severe middle-ear barotrauma or forceful Valsalva maneuver. […] Alternobaric vertigo occurs during descent, ascent or immediately after surfacing from a dive and is caused by unequal pressure stimulation in each ear. […] Pressure must be released from the middle ear as the diver ascends, or the expanding air will bulge and even rupture the eardrum. […] Facial baroparesis is reversible paralysis of the facial nerve due to increased pressure in the middle ear when ascending in an airplane or from scuba diving. […] The facial nerve is a cranial nerve that controls the muscles of the face. […] In some people, the canal of facial nerve misses the bony wall and is separated from the middle-ear cavity by only a thin membrane.

• #24 Should You Stop Flying if You Have a Severe Ear Infection? | Harley Street ENT Clinic

  https://www.harleystreetent.com/blog/should-you-stop-flying-if-you-have-a-severe-ear-infection

  If this happens then your ears can feel uncomfortable as they wont pop properly. […] The worse your ear infection is, the more likely your ears are to get clogged up and experience these kinds of problems when you fly. […] In the worst cases, if the inner ear is sucked in by lower pressure inside the middle ear, it could cause lasting damage to your hearing. […] A burst eardrum can be very painful and it will take several weeks to heal. […] In very rare cases, the inner ears can be damaged when you fly with a bad ear infection. This could cause lasting damage to your hearing.

• #25 Flying with otitis: is flying with an ear infection dangerous?

  https://www.medical-air-service.com/blog/flying-with-otitis-is-flying-with-an-ear-infection-dangerous_8553.html

  Otitis refers to an infection or inflammation in the ear. […] Because of the change in pressure in the plane cabin, flying with an ear infection can be dangerous. […] Potential complications may include extreme air pain, a ruptured ear drum or hearing loss. […] The main problem of flying with an ear infection is due to the change in air pressure at different altitudes. […] The build-up of fluid in your ear makes it impossible for air to pass through in and out of your ears. […] In case of a severe ear infection, you might experience the following medical complications during and after a flight: Extreme ear pain, Dizziness, Hearing loss (both permanent and temporary), Ruptured eardrum. […] However, if the otitis is severe and the risk of flying is too high because of the change in air pressure, then you might be declared unfit to fly commercially.

• #26 Ear Problems and Flying | Articles | YBW Aeromedical Clinic

  https://www.aviationdoc.com/articles/2016-11-14-ear-problems-and-flying

  If you allow your ears to become locked, it may be impossible to correct. […] Most ground-based physicians are not used to examining the eardrums of aircrew. You will usually be told that you have an ear infection because the doctor sees a bloody red eardrum. This in fact, is not true, as what has happened is bleeding into the eardrum from pressure, not infection. […] Generally, I allow crews to fly with pressures between +10 and -40 decapascals. Pressures outside of these limits often result in discomfort or, in the worst case, eardrum rupture.

• #27 Myringitis (Middle Ear, Tympanic Membrane, Inflammation): Practice Essentials, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/858558-overview

  Myringitises can develop as self-maintained primary disease of the TM (primary myringitis) or as an effect of an inflammatory process of adjacent tissues of the external or middle ear (secondary myringitis). The etiology and pathogenesis of primary myringitis and secondary myringitis are significantly different, and they require different treatments. Therefore, they should be considered separately. […] An explosion, a change in the pressure in an airplane cabin, a blow to the ear with the palm, or even a kiss in the ear can cause trauma to the TM. […] The TM is involved in the initial stage of acute otitis media (AOM), the stage when negative pressure is formed in the middle ear space. […] Increased inflammation in the middle ear results in bulging of the TM, with possible perforation. This is accompanied by intense earache and by typical clinical manifestations of AOM.

• #28 Myringitis (Middle Ear, Tympanic Membrane, Inflammation): Practice Essentials, Pathophysiology, Epidemiology

  https://emedicine.medscape.com/article/858558-overview

  In untreated patients, as middle ear pressure increases, the TM eventually perforates, pain decreases, and mucopurulent discharge with blood appears in the EAC. […] Similar phenomena occur in cases of viral myringitis (influenza). With viral myringitis, as with acute bullous myringitis, bubbles filled with blood form on the surface of the TM and burst with effusing blood; however, the TM is not perforated. […] Chronic inflammation of the TM accompanies inflammation of the middle ear. On the surface of the TM, the epidermis is actively displaced into the ear canal, and, in 15% of cases, it may penetrate through small perforations of the TM.

• #29 Ear Pain During Flight Can Be a Sign of Some Diseases! | Yeditepe Üniversitesi Hastanesi

  https://yeditepehastaneleri.com/en/health-guide/pains/ear-pain-during-flight-can-be-sign-some-diseases

  „If treatment is delayed, problems such as collapse of the eardrum, inflammation in the ear, and perforation of the eardrum may occur.” […] „If the nasal congestion is too severe, ear pain during the flight can cause damage to the eardrum and inner ear.” […] „Therefore, in addition to nose problems, balloon dilation of the Eustachian tube may also be necessary in individuals with chronic Eustachian tube problems and associated hearing loss.”

• #30 Airplane ear – Diagnosis & treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/airplane-ear/diagnosis-treatment/drc-20351707

  Diagnosis of airplane ear, also called ear barotrauma, is based on medical history and an exam of the ear with a lighted tool called an otoscope. […] For most people, airplane ear heals with time. When the symptoms don’t go away, treatments to even out the pressure might help symptoms of airplane ear. […] But, rarely, you might need an office procedure or surgery to treat airplane ear. In one such procedure, a surgeon makes a cut in the eardrum to even out the air pressure and drain fluid. This is called a myringotomy.

• #31 Problems with ears on flight – Rick Steves Travel Forum

  https://community.ricksteves.com/travel-forum/transportation/problems-with-ears-on-flight

  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. […] Signs of airplane ear might include a slight outward or inward bulging of your eardrum. If your condition is more severe, your doctor may see a tear in the eardrum or a pooling of blood or other fluids behind your eardrum. […] Your doctor may prescribe medications or direct you to take over-the-counter medications to control conditions that may prevent the eustachian tubes from functioning well. […] To do this, you pinch your nostrils shut, close your mouth and gently force air into the back of your nose, as if you were blowing your nose. Once the medications have improved the function of the eustachian tubes, use of the Valsalva maneuver may force the tubes open.

• #32 Airplane Ear: Causes, Symptoms, and Treatments | SELF

  https://www.self.com/story/understanding-airplane-ear?hootPostID=3796e69d3b4a6f188d0f558381d07f81

  Long-term complications may occur when the condition is serious or prolonged or if there’s damage to middle or inner ear structures. […] Your doctor may suggest a hearing test (audiometry) to determine how well you detect sounds and whether the source of hearing problems is in the inner ear. […] If you’re prone to severe airplane ear and must fly often, your doctor may surgically place tubes in your eardrums to aid fluid drainage, ventilate your middle ear, and equalize the pressure between your outer ear and middle ear.

• #33 Ear Barotrauma: Causes, Diagnosis and Treatments

  https://www.healthline.com/health/ear-barotrauma

  Ear barotrauma is a condition that causes ear discomfort due to pressure changes. […] Eustachian tube blockage is one of the causes of ear barotrauma. The eustachian tube helps to restore equilibrium during changes in pressure. […] Altitude changes are the most common cause of this condition. One of the places many people experience ear barotrauma is during an airplanes ascent or descent. The condition is sometimes referred to as airplane ear. […] Middle ear barotrauma is particularly common in divers, as the pressure underwater changes drastically. […] In severe or chronic cases of barotrauma, surgery may be the best option for treatment. Chronic cases of ear barotrauma may be aided with the help of ear tubes. […] Ear barotrauma is usually temporary. However, complications may arise in some people, especially in chronic cases. […] The majority of those who experience ear barotrauma will make a full recovery, with no permanent hearing loss. […] You can decrease your risk of experiencing barotrauma by taking antihistamines or decongestants before scuba diving or flying on a plane.

• #34 Chapter 2: Injuries – Divers Alert Network

  https://dan.org/health-medicine/health-resource/dive-medical-reference-books/ears-diving/ear-injuries/

  Middle-ear barotrauma is the accumulation of fluid and blood in the middle ear or rupture of the eardrum as a consequence of failed equalization of pressure in the air space of the middle ear during diving or flying. […] An obstruction in the Eustachian tube can lead to an inability to achieve equalization particularly during a descent when the pressure changes fast. […] Factors that can contribute to the development of MEBT include the common cold, allergies or inflammation conditions that can cause swelling and may block the Eustachian tubes. […] Inner-ear barotrauma is damage to the inner ear due to pressure differences caused by incomplete or forceful equalization. […] If the pressure in the middle ear is not equalized during descent, the water pressure on the eardrum transfers inward through the middle-ear ossicles to the oval windows, and the round window bulges outward.

• #35 Middle ear barotrauma – Wikipedia

  https://en.wikipedia.org/wiki/Middle_ear_barotrauma

  Middle ear barotrauma (MEBT), also known to underwater divers as ear squeeze and reverse ear squeeze, is injury caused by a difference in pressure between the external ear canal and the middle ear. […] Failure to equalise may be due to inexperience or eustachian tube dysfunction, which can have many possible causes. Unequalised ambient pressure increase during descent causes a pressure imbalance between the middle ear air space and the external auditory canal over the eardrum, causing inward stretching, serous effusion and haemorrhage, and eventual rupture. […] During ascent internal over-pressure is normally passively released through the eustachian tube, but if this does not happen the volume expansion of middle ear gas will cause outward bulging, stretching and eventual rupture of the eardrum known to divers as reverse ear squeeze.

• #36 Otic Barotrauma – Ear, Nose, and Throat Disorders – MSD Manual Professional Edition

  https://www.msdmanuals.com/professional/ear-nose-and-throat-disorders/middle-ear-and-tympanic-membrane-disorders/otic-barotrauma

  If patients have eustachian tube dysfunction are treated with hyperbaric oxygen and experience similar symptoms during their first hyperbaric treatment, they require placement of tympanostomy tubes. […] Tubes should be placed prophylactically for patients who have known eustachian tube dysfunction. […] If hearing loss is sensorineural and vertigo is present, a perilymphatic fistula is suspected and middle ear exploration to close a fistula should be considered.

• #37 Middle-ear pain and trauma during air travel

  https://pmc.ncbi.nlm.nih.gov/articles/PMC4298289/

  To prevent middle-ear pain and trauma during air travel, with minimal adverse effects. […] Symptoms and signs that arise from air pressure changes across the eardrum. […] Barotrauma Symptoms resulting from severe air pressure changes across the eardrum causing physical changes to the eardrum and/or middle ear. […] The middle ear can fill with exudate or blood, and a weakened eardrum can perforate, resulting in a blood-stained discharge. […] Oral pseudoephedrine compared with placebo may prevent symptoms in adults with previous ear pain during flights. […] There is a statistical benefit from oral pseudoephedrine, although it is difficult to tell if this is of practical use. […] Using a systemic decongestant to reduce the chance of barotitis is consistent with the mechanism of the problem, and the improvement with oral pseudoephedrine makes it worth recommending provided that the person does not have hypertension or coronary artery disease. […] Oral pseudoephedrine may be no more effective at preventing ear pain at take-off or landing compared with placebo in children (low-quality evidence).

• #38 Airplane Ear: How To Unclog Ears Clogged After a Flight

  https://www.health.com/mind-body/ears-clogged-airplane-flight

  Getting on a plane while you’re sick with a cold or other head infection that triggers nasal congestion makes those changes in air pressure even worse. Active ear or sinus infections can cause pain or injury since it’s hard to equalize the pressure in your ears. […] Ear barotrauma can have potential complications. These complications are problems such as: […] It’s possible to prevent airplane ears in the first place. […] Airplane ears can be preventable if you take measures including wearing ear plugs when your flight takes off or lands, sleeping only when the plane is in the air, and taking a decongestant 30 minutes to an hour before your flight.

• #39 Ears, Altitude and Airplane Travel – Lexington Clinic

  https://lexingtonclinic.com/services/associate-practices/kentucky-ear-nose-and-throat/patient-resources/ears-altitude-and-airplane-travel

  Ears, Altitude and Airplane Travel […] It is the middle ear that causes discomfort during air travel, because it is an air pocket inside the head that is vulnerable to changes in air pressure. […] Air travel is sometimes associated with rapid changes in air pressure. To maintain comfort, the Eustachian tube must open frequently and wide enough to equalize the changes in pressure. […] If you have a cold, a sinus infection or an allergy attack, it is best to postpone an airplane trip. […] If your ears fail to open or if pain persists, you will need to seek the help of a physician who has experience in the care of ear disorders.

• #40 Preventing Ear And Sinus Pain While Flying – ENT Care, Rockville, MD – Siegel, Bosworth and Sorensen Division

  https://ent-md.com/preventing-ear-and-sinus-pain-while-flying/

  You should avoid flying if your nose is congested from a cold or allergies. In the most severe case, this may lead to a permanent decrease in your hearing, prolonged dizziness, or severe pain. Most patients who experience a decrease in hearing associated with severe pain after a plane flight have a readily reversible hearing loss and should be seen by an otolaryngologist (ENT) within several days of the event, as this makes it easier to correct the problem.

• #41 The Science Behind Airplane Ear: Understanding How Ear Plugs Help — robertleeqa

  https://robertleeqa.mataroa.blog/blog/the-science-behind-airplane-ear-understanding-how-ear-plugs-help/

  The key lies in their ability to create a seal within the ear canal, which helps regulate the pressure inside the ear. When properly inserted, ear plugs create a barrier that prevents rapid pressure changes from affecting the Eustachian tube. This allows the Eustachian tube to function more effectively, equalizing the pressure on both sides of the eardrum. As a result, the discomfort and pain associated with airplane ear are significantly reduced. […] Understanding the science behind airplane ear and how ear plugs can help is essential for a comfortable and enjoyable air travel experience. By creating a seal within the ear canal, ear plugs can regulate the pressure inside the ear and alleviate the symptoms of airplane ear.

• #42 How to stop ears from popping on a plane​?

  https://www.amplifon.com/uk/audiology-magazine/airplane-ear-problems

  Air transport occurs at high altitude, usually around 10,000 meters. At higher altitudes, the air pressure decreases, which can cause ear problems. […] The mechanism that creates earache is linked to the air pressure inside the aircraft cabin, which increases rapidly without the Eustachian tube, the small duct that connects the middle ear with the nose, being able to react efficiently to the sudden change in pressure. The consequence is a retraction of the tympanic membrane and consequent muffling and pain. […] Sudden changes in atmospheric pressure can create an imbalance that causes an increase in pressure on the tympanic membrane. Hence the pain and other related symptoms. […] The use of earplugs during air travel is an excellent practice to prevent discomfort caused by pressure variations. Earplugs not only protect the hearing from excessive pressure on the ear, but also help to better compensate for differences in air pressure. This reduces the sensation of pain in the ears during take-off and landing, thus ensuring a more comfortable journey.

• #43 “Airplane ear”—A neglected yet preventable problem

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6779601/

  Generally, airplane ear does not pose problems unless there is any structural damage in the middle ear. […] The valsalva manoeuvre can be performed by the passengers during passengers feel ear discomfort in the aeroplane. […] For frequent fliers, surgically placed tube in the eardrums is generally helpful to aid fluid drainage in the middle air, particularly for those who are prone to severe airplane ear. […] Airplane ear is a common yet, ignored public health problem.

• #44 How Do You Get Rid of Airplane Ears? 7 Home Remedies

  https://www.medicinenet.com/how_do_you_get_rid_of_airplane_ears/article.htm

  There is no need for active management for airplane ear because it heals with time. However, if the pain persists certain treatments that stabilize the pressure within the eustachian tubes are to be done. […] The use of nasal decongestants in the form of a pill or a nasal spray decreases the formation of mucus in the nose and eustachian tube. […] Usually, surgical intervention for an airplane ear is not indicated. Even mild cases of eardrum perforations may heal on their own. […] Myringotomy is a small procedure that involves making an incision in the eardrum to equalize air pressure and drain fluids.

• #45 Airplane Ear – Understanding treatment perspectives | Healthylife

  https://www.healthylife.com.au/learn/airplane-ear-understanding-treatment-perspectives?srsltid=AfmBOoq6exOUtJlcuq_IZZ_f24Ls21ZZ9faE7H4PZNiR0XaOFYqHhTmL

  Lastly, it is important to note that any situation or activity in which rapid altitude or pressure changes occur can cause ear barotrauma. […] The most important preventive measure is to avoid flying when symptoms of upper respiratory tract infection are present. […] Numerous sources recommend prophylactic and therapeutic use of oral or topical nasal decongestants to prevent and treat middle-ear barotrauma. […] Pseudoephedrine should improve or maintain eustachian tube patency and allow equilibration of middle-ear pressures. […] A steroid nasal spray may be advised if an allergy or other cause of persistent inflammation in the nose is suspected. […] Myringotomy involves creating a small incision or hole in the eardrum.

• #46 Ear Barotrauma: Symptoms, Causes, Treatment, Prevention

  https://www.webmd.com/a-to-z-guides/ear-barotrauma-facts

  Ear barotrauma, also known as airplane ear, is that clogged-up, sometimes painful feeling you get in your ears when the air pressure changes quickly. […] If the eustachian tube malfunctions and theres a pressure difference across the eardrum, pain or ear squeeze happens. […] You may be at risk if you have a problem with your eustachian tube where it doesnt open normally. […] Regardless of why you feel the pain, your doctor will look inside your ears with a tool called an otoscope. […] If it isn’t better in 2 months, you may need an operation to prevent lasting hearing loss. […] Serious damage, such as a burst eardrum, may take a few months to heal. […] Initial treatment involves oral decongestants and nasal spray to help open the eustachian tube. […] A ruptured eardrum will need antibiotics by mouth to prevent infections.

• #47 Is It Safe to Fly With an Ear Infection? ENT Doctors in Raleigh Explain

  https://www.raleighcapitolent.com/blog/safe-to-fly-with-an-ear-infection

  A swollen or blocked Eustachian tube makes it difficult for your ears to equalize pressure. […] When the tube is blocked, it creates a small vacuum that stretches the eardrum. If the tube remains blocked, fluid collects in an attempt to overcome the vacuum and alleviate pressure. The result is called serous otitis or aero-otitis. […] If at all possible, its best to avoid flying when you or your children have an ear infection or a sinus infection. These block the Eustachian tubes, placing additional pressure on the eardrum. […] Whenever there is continual, increased pressure on the eardrum, it can rupture. […] While flying with an ear infection doesnt always result in a ruptured eardrum, it can be very painful and uncomfortable. […] A warm compress or over-the-counter medicines can treat pain from a ruptured eardrum. […] If the problem is caused by bacteria, and not a virus, your doctor can prescribe antibiotics to help. […] An ear infection can hamper any vacation or interfere with business travel.

• #48 Airplane ear – Augusta HealthSearchClose SearchSearch IconSearch IconClose Search IconMobile Menu IconMobile Menu Close IconInstagramFacebookTwitterYoutube

  https://www.augustahealth.com/disease/airplane-ear/

  Airplane ear (ear barotrauma) is the stress on your eardrum that occurs when the air pressure in your middle ear and the air pressure in the environment are out of balance. […] Airplane ear occurs when the air pressure in the middle ear and the air pressure in the environment don’t match, preventing your eardrum (tympanic membrane) from vibrating normally. A narrow passage called the eustachian tube, which is connected to the middle ear, regulates air pressure. […] When an airplane climbs or descends, the air pressure changes rapidly. The eustachian tube often can’t react fast enough, which causes the symptoms of airplane ear. Swallowing or yawning opens the eustachian tube and allows the middle ear to get more air, equalizing the air pressure. […] Surgical treatment of airplane ear is rarely necessary. Even severe injuries, such as a ruptured eardrum or ruptured membranes of the inner ear, usually heal on their own. […] However, in rare cases, an office procedure or surgery might be needed. This might include a procedure in which an incision is made in your eardrum (myringotomy) to equalize air pressure and drain fluids.

• #49 Flying with otitis: is flying with an ear infection dangerous?

  https://www.medical-air-service.com/blog/flying-with-otitis-is-flying-with-an-ear-infection-dangerous_8553.html

  Particularly useful for patients with an ear infection, air ambulances can fly at sea level. […] In a sea-level flight, the pressure inside the plane cabin can be adjusted so that it is closer to the pressure at sea level, which will prevent your ear infection from worsening and resulting in more life-threatening complications.

• #50 Ear barotrauma – UpToDate

  https://www.uptodate.com/contents/ear-barotrauma

  Ear barotrauma occurs when pressure differences between the middle ear and the outside environment distort the tympanic membrane (TM), leading to discomfort, hearing loss, and injury. […] Pressure within the middle ear must match that of the environment for the TM to vibrate normally. During normal physiologic function, air in the middle ear is absorbed slowly by the mucous membrane lining and is continually replaced by the opening of the Eustachian tube. […] The Eustachian tube extends from the middle ear to the nasopharynx and is made up of two parts: The posterior half leading from the ear is a bony tube lined with mucosa that does not change shape.

• #51

  https://ijmscrr.in/index.php/ijmscrr/article/view/1054

  Ear barotrauma is a frequent condition caused by rapid pressure changes during air travel, primarily affecting the middle ear due to Eustachian tube dysfunction. […] This review discusses the pathophysiology, risk factors, clinical manifestations, diagnosis, management, and prevention of air travel-related ear barotrauma. […] Evidence-based preventive strategies and treatment options are highlighted to minimize its impact on travellers.

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