Flight-Related Ear Discomfort (how to "pop" your ears when you fly)

[K.C.]

Dr. Steve,

I went on vacation, felt some pain in my right ear during the flight which I attributed to the altitude. It subsided a little bit after I was on the ground.

Went swimming a few days while I was on vacation, flew back and felt the same ear pain, but worse this time, during the flight. I took some ibuprofen for the pain when I got back, and it was fine...it hasn't really hurt ever since, except a little bit when I went to sleep last night, but it's felt clogged.

Woke up today and it still feels clogged, and it definitely feels like there's some water stuck in there, but I can't get it out.

I don't think I have swimmer's ear, or an infection, because I've had both and remember what type of pain that is.

There's a possibility that it could be a blockage, although I used one of those ear cleaning packs with the drops and bulb syringe and while a little wax cleared out, there wasn't a ton.

Have you ever heard of any type of thing where your ears swell or the canals tighten from flying and this is just a naturally occurrance?

Or, is this definitely an infection/blockage/swimmer's ear type of thing?


Oh, I've also been a bit congested the last couple days. Could this play in to that?

[Dr Steve]

Dr. Steve,

Similar, but somewhat different problem (I think).

I went on vacation, felt some pain in my right ear during the flight which I attributed to the altitude. It subsided a little bit after I was on the ground.

Went swimming a few days while I was on vacation, flew back and felt the same ear pain, but worse this time, during the flight. I took some ibuprofen for the pain when I got back, and it was fine...it hasn't really hurt ever since, except a little bit when I went to sleep last night, but it's felt clogged.

Woke up today and it still feels clogged, and it definitely feels like there's some water stuck in there, but I can't get it out.

I don't think I have swimmer's ear, or an infection, because I've had both and remember what type of pain that is.

There's a possibility that it could be a blockage, although I used one of those ear cleaning packs with the drops and bulb syringe and while a little wax cleared out, there wasn't a ton.

Have you ever heard of any type of thing where your ears swell or the canals tighten from flying and this is just a naturally occurrance?

Or, is this definitely an infection/blockage/swimmer's ear type of thing?


Oh, I've also been a bit congested the last couple days. Could this play in to that?

A very interesting question!

I think your story best fits something called barotrauma. Let me walk you through it and see if you agree.

http://www.tchain.com/otoneurology/images/master-ear.jpg

First, every air-filled cavity in the body has a tube going to the outside world that allows air pressure to be adjusted so the pressure inside the body equals the pressure outside. When flying, or driving in the mountains, you'll feel this equilibration when your ears "pop". The tube that equalizes pressure in the middle ear is the eustachian tube. It goes from the inner ear to the back of the throat and is surrounded by the adenoids.

When flying, if you're ascending, the outside pressure drops and the eardrum bulges out. Yawning will open the eustachian tube, allowing the pressure to equalize. If you're descending, the pressure outside increases, and your eardrums bulge in. Yawning won't work in this case, you need to blow air into the middle ear by doing a valsalva maneuver. (The valsalva is done thusly: hold your nose, extend your neck forward, and blow your cheeks out...if you do this correctly, you'll feel the eardrums "pop" outward.)

So remember, yawn going up, blow coming down. There's probably a joke in there somewhere, but I'm not funny enough to find it. :-)

In your case, you've been congested. Your eustachian tube is probably harder to open because of this (being surrounded by the immune-reactive tissue the adenoids doesn't help). When you went up, the pressure probably equalized, but coming back down, your ears were traumatized by the pressure on the drums. It's similar to cramming a qtip into your ear, or diving deep in water without popping your ears. I've seen people actually perforate their eardrums after a flight.

Your eardrum is likely to be thickened right now from inflammation caused by the trauma (baro=pressure, trauma= trauma--> barotrauma) and it'll make your ear feel clogged. If it's not draining, and there's no pain, you can probably wait and see if it'll go away. If it's draining, or there's pain, or it doesn't go away, get your eardrums checked. Your family doctor or an ear/nose/throat doctor can take a look at it.

Hope this helps!



Steve

[K.C.]

Thanks for the help, and it's something I'll have to keep in mind for flying in the future.

Right now, my hearing feels ok, but the description you gave of barotrauma kind of bares out what the ear feels like right now.

There is a slight bit of dull pain, but nothing that I would describe as uncomfortable yet.

If the pain is worse when I wake up tomorrow, I'll probably get checked out.