The discomfort felt during air travel during take off or landing due to significant altitude change. One important function of the middle ear is it is always striving to maintain equal pressure with it's outside environment. Even though commercial aircraft cabins are pressurized to provide stable air pressure equal to an elevation of 8000 feet, the workout on the ear is still rigorous.
During take-off, air in the middle ear is released through the Eustachian tube as it moves from a high level of air pressure to a low level acting like a two-way vent. The Eustachian tube is a membrane-lined tube, comparable in size to a pencil lead, connecting the back of the nose to the middle ear.
During descent, however, this process is complicated as the inward flow of air pressure is resisted by the Eustachian tube.
When the Eustachian tube becomes blocked, air is no longer replenished in the middle ear. When all of the air is absorbed, a resultant vacuum effect pulls the ear inward causing swelling, vibratory disturbance (muffled sound) and pain.
If remained blocked for some time, fluid (blood serum) will leak into the ear in an effort to overcome the vacuum with an end result of "fluid in the ear", serous otitis, or baro-otitis. The common cold, sinus infection, allergies, hay fever, ear infections, narrow Eustachian tubes as result of recurrent childhood ear infections, and the small Eustachian tubes of babies/small children are all prone to the effects of Eustachian tube dysfunction.
If it is not possible to postpone a flight in the middle of an upper respiratory infection, the use of a decongestant or nasal spray will help in the reduction of Eustachian tube swelling.
Earplugs help to slow the rate of pressure change during take off and landing by gradually allowing air to seep into the ear canal.
Activation of the muscle that opens the Eustachian tube equalizes pressure in the middle ear. This muscle is responsive to chewing, swallowing, drinking, yawning, and opening mouth widely. Ensure babies are awake during descent and are given a bottle or a pacifier.
Adapted from the article Barometric Changes and the Ear, by Barbara Tabachnick in Tinnitus Today (June 1997) and information obtained from the American Academy of Otolaryngology Head and Neck Surgery Inc. website.
