Airplane Ear: Causes, Symptoms, Diagnosis, and Treatment

The airplane ear also called barotrauma of the ear occurs when there is an imbalance to maintain the pressure changes in the environment by the Eustachian tube. The airplane is an important ear problem that is more painful in children and babies because of the incomplete development of the ear. The pressure is maintained by the eustachian tube which connects the middle ear to the nose and throat. The eustachian tube is closed the person experiences airplane ear.

Airplane ear is the condition in which there is physical damage to the ear affecting mainly the middle ear. It can also affect the outer and inner ear. The external ear is affected when there is a trapping of high air pressure in the external auditory canal. The inner ear is affected rarely. Airplane ear can also happen in conditions like scuba diving, diving in the mountains, and flying. Even ear infections and eustachian tube dysfunction can also cause the condition.

Diagnosis and treatment of airplane ear are very important as it leads to complete loss of hearing. Diagnoses are based o the presence of symptoms only during the pressure changes and disappear once the pressure has been normalized. It is treated based on the amount of ear affected and the decision is made accordingly.

Airplane Ear: Causes

The airplane ear is mainly caused by pressure changes inside and outside the ear. The important causes which can lead to pressure changes include −

  • While flying the flights mainly occurs while ascending or descending because more pressure changes. One should not sleep while the plane is taking off and while lading

  • During diving

  • Blockage of the Eustachian tube

  • Individuals having a history of ear infections and ear congestion are more sensitive to even mild pressure changes

  • Patients having Eustachian tube dysfunction

Airplane Ear: Symptoms

The airplane ear mainly presents with the following symptoms −

  • Discomfort in the ear

  • Blockage of the ears

  • Reduced hearing

  • Ear pain and bleeding can be present

  • Bleeding in the nose

  • The feeling of imbalance and dizziness

  • Sensation of fullness

  • Recurring pain

  • If the perforation of the eardrum is present the patient presents with loss of hearing, Fringing in the ears, discharge from the ears, and nausea.

Airplane Ear: Risk Factors

The risk factors which increase the occurrence of the airplane ear are the conditions that cause the blockage of the Eustachian tube. These include −

  • Babies and young children are at the most risk because of the small eustachian tube

  • Individuals having flu( common cold)

  • History of sinusitis

  • Allergic rhinitis

  • Sleeping during the takeoff and landing of the plane can increase the risk

Airplane Ear: Diagnosis

The diagnosis of the airplane ear is based on the appearance and disappearance of the symptoms. The symptoms of the airplane ear are present when lading the planes and the symptoms are reduced once the plane land. But if the symptoms persist should visit the doctor immediately to avoid further complications.

Some of the tests done are −

  • Audiometry − To assess the amount of hearing

  • Tympanometry − To assess the eardrum pressure

Airplane Ear: Treatment

Airplane ears should be treated early as they can lead to serious complications. Once it has been diagnosed as airplane ear immediate self-care has to be done to reduce the pressure followed by various other treatments. It includes −

  • Self-care steps − The following self-care steps act by helping the eustachian tube to open and to regularise the pressure.

    • Breathing exercises

    • Yawning and drinking

    • Chewing gum

    • Taking decongestants

    • The patient should be awake while taking off and landing the planes

    • Blowing the nose gently

  • First aid − Initial treatment of an airplane includes giving basic life support such as maintenance of the airway, breathing, and circulation (ABC). Assessment of the nervous system and immediate management of life-threatening conditions should be done.

  • Surgical management − It is usually not necessary as the airplane resolves on its own. Myringotomy can be considered in severe or recurrent patients which acts by maintaining the pressure changes by draining the fluid present.

  • Ear tubes − These are preferred in patients having a recurrent history of airplane ear and required to travel often by planes.

Some of the medicines such as nasal decongestants, nasal sprays, and steroids should be given immediately to help open the Eustachian tube

Airplane Ear: Prevention

Prevention of the airplane ear is very important as it is a temporary condition avoiding some things and immediate measures can reduce the occurrence of airplane ear. Prevention of the airplane ear can be done by following measures −

  • Avoid traveling by flight when the individual has a common cold and sinusitis

  • Do not sleep while taking off and landing the plane as one can immediately follow the self-care steps above mentioned to reduce the occurrence of the airplane ear if the individual starts experiencing any discomfort in the ear

  • Carrying decongestant medicines, and anti-allergic sprays are advised in patients having cold or allergy

  • Yawing and drinking water or swallowing can help the patient avoid airplane ear


The airplane era is a condition that occurs when a person travels in a flight and is mainly because of the failure of the eustachian tube to maintain the pressure changes occurring outside the ear commonly during the taking off and landing of the planes. It is a temporary condition that usually resolves on its own. But if the symptoms are persistent for a long time should be considered to consult a doctor and necessary treatment should be taken

The symptoms are mainly present during the high pressures and diagnosis is clinically done on the history and the presentation. No laboratory investigation is usually required. Common colds, allergies, and sinus infections can increase the condition. Hence taking decongestants, anti-allergic medicines, and steroid nasal sprays can prevent airplane ears, and also avoid sleeping during takeoff and landing of the planes. Babies and children should be avoided traveling on the flights as they are at more risk.

Dr. Durgesh Kumar Sinha
Dr. Durgesh Kumar Sinha


Updated on: 16-Feb-2023


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