A real pain in the ear – what happens to your ears during a flight?

airplane ear
4 min read

Barotrauma, barotitis media or aerotitis media – if you’ve ever flown, chances are that you have experienced it.

More commonly known as airplane ear, we’ve all fell victim to it on one or more occasion – the plane descends, pressure inside the cabin changes, and our ears may pop or we experience pain.

Did you know whether you are flying first class, business or economy class, airplane ear does not discriminate and in some instances the low-key yawn won’t even be your saving grace?

According to Mayo Clinic, there are also instances where the ear pain and pressure can lead to severe pain and hearing loss, so it is best to take precautions, before, during and after your flight, with these guidelines from The Association of Southern African Travel Agents (ASATA).

earsHow it happens

Healthy Hearing explains that it all comes down to air pressure. Normally the air pressure inside the inner ear and outside are essentially the same, or at least not different enough to cause any trouble. A problem only occurs when the change in altitude is so rapid, like it is in air travel, that the pressure inside the inner ear and the air pressure outside don’t have time to equalise.

Imagine muffins baking in an oven and rising. Now, this is equal to what happens to your years when an airplane takes off and starts to gain altitude. The air pressure inside the inner ear quickly exceeds that of the pressure outside and the eardrum swells outward. The opposite is of course relevant when a plane descends. The pressure in your eardrum becomes less than the air pressure outside, and your eardrum gets sucked inward, almost like a vacuum effect or that of a souffle falling flat.

This is also why the Mayo Clinic warns that if you are very sick with a cold, the flu, allergies or congestion, you should consider changing your travel plans if possible. Not only will your fellow travellers appreciate one less sick person spreading germs around the plane’s cabin, your illness can cause a blockage in the Eustachian tube, preventing the necessary equalisation of pressure. A ruptured eardrum or severe infection can occur which can cause hearing loss or permanent ear damage. Also read why you are more likely to get sick on an airplane


What does and does not work

From yawning to chewing gum to placing wet cloths over your ears during take-off and landing, there are some simple ways to prevent or deal with airplane ear, but not all of them always work.

Dutch carrier KLM gives the following recommendations:

• Swallowing and yawning opens the Eustachian tube so that air will be able to reach the inner ear during descent.
• Even if you keep having problems long after the landing, it will still help when you keep swallowing.
• ‘Cope’ with it. There are a few other methods, which KLM refers to as ‘coping’ such as blowing your nose, chewing gum, or drinking while pinching your nose closed. Whichever of these methods you find works best for you should be repeated a few times during the complete descent.
• Just breathe. KLM suggests passengers breathe in, then gently breathe out with their mouth closed while pinching their nose (it’s known as the Valsalva manoeuvre). In this way, no air will be exhaled but you will be gently pushing air into the Eustachian tube. While doing this you may feel your ears go “pop” as air is pushed into the inner ear. This often solves the problem.
• It is not advised to sleep during descent. After all, you can only try these tips to equalise the pressure either side of your eardrums as long as you are you are awake.
• If you have a cold, your ears are not completely blocked and you still want to fly you could try a decongestant nasal spray. One such spray, containing Xylomethalozine for example, is readily available at pharmacies. This can temporarily dry up mucus in the nose, thereby helping to open the Eustachian tube if it’s blocked by mucus.
• To encourage them to swallow, give babies or small children a drink or pacifier during descent.

On the flip side, sometimes you might hear other “never fail” remedies. Well, at the risk of disappointing anyone, the truth is that there is no medical evidence to support putting wet cloths over your ears, for example, or covering them with cups, unless you want to be part of the in-flight entertainment.

The same can be said for using eardrops or cleaning your ears. They may have a soothing effect, but they will do nothing for the pain. At some airports you can also buy earplugs that regulate changes in air pressure. These earplugs only slow the rate of air pressure change on the eardrum. However, although not evidence based, from a medical point of view, if you find that they help, use them.