7 Common Symptoms of Airplane Ear You Should Know

Airplane ear, medically known as ear barotrauma or barotitis media, is a common condition that occurs when there’s an imbalance between the air pressure in the middle ear and the air pressure in the environment. This typically happens during air travel, particularly during takeoff and landing when altitude changes rapidly. The eustachian tube, which normally equalizes pressure, may struggle to keep up with these quick changes, leading to discomfort and various symptoms.

While airplane ear is usually temporary and mild, understanding its symptoms can help you recognize the condition early and take appropriate measures. Most cases resolve on their own within a few hours to a few days, but some symptoms may require medical attention if they persist or worsen.

1. Ear Discomfort or Pain

The most common symptom of airplane ear is a feeling of discomfort or pain in one or both ears. This sensation typically begins during the plane’s descent but can also occur during ascent. The pain ranges from mild pressure to sharp, stabbing sensations that can be quite uncomfortable.

The intensity of the pain varies depending on how quickly the pressure changes and how well your eustachian tubes can equalize that pressure. Some people describe it as a dull ache, while others experience more acute pain. Children are particularly susceptible to this symptom because their eustachian tubes are smaller and less efficient at pressure equalization.

The discomfort usually affects the middle ear, where the pressure imbalance is most pronounced. If you have a cold, sinus infection, or allergies, the pain may be more severe because these conditions can cause inflammation and block the eustachian tubes, making pressure equalization even more difficult.

2. Feeling of Fullness or Stuffiness in the Ear

Many people with airplane ear experience a sensation of fullness, stuffiness, or blockage in their ears, similar to having cotton balls stuffed in them. This feeling occurs because the negative pressure in the middle ear causes the eardrum to be pulled inward, creating a sensation of congestion even when there’s no actual mucus buildup.

This symptom can be particularly bothersome because it affects your perception of your surroundings. Sounds may seem muffled or distant, and you might feel disconnected from your environment. The sensation of fullness can persist for several hours after landing, sometimes even lasting for a day or two in more stubborn cases.

Unlike actual ear congestion from a cold or infection, this fullness is purely mechanical – it’s the result of pressure differences rather than fluid accumulation. However, if you already have congestion from an upper respiratory infection, the combination can make the stuffiness feel even more pronounced.

3. Muffled Hearing or Temporary Hearing Loss

Reduced hearing ability is a frequent symptom of airplane ear. When the eardrum cannot vibrate properly due to pressure imbalance, sound transmission to the inner ear is impaired. This results in muffled hearing, where sounds seem quieter or less clear than normal.

The degree of hearing impairment can vary from slight muffling to significant temporary hearing loss. You might find yourself asking people to repeat themselves or having difficulty following conversations. Some people describe it as hearing underwater or through a thick barrier.

This symptom typically affects both the volume and clarity of sounds. High-frequency sounds may be particularly difficult to hear. In most cases, hearing returns to normal once the pressure equalizes and the eardrum returns to its proper position. However, if hearing loss persists for more than a few days after your flight, it’s important to consult a healthcare provider to rule out more serious complications.

4. Ringing in the Ears (Tinnitus)

Tinnitus, or ringing in the ears, is another common symptom associated with airplane ear. This can manifest as ringing, buzzing, humming, hissing, or other phantom sounds that seem to come from inside your ear or head. The sound may be constant or intermittent and can range from barely noticeable to quite distracting.

The tinnitus associated with airplane ear occurs because the pressure changes affect the delicate structures of the inner ear and the way your auditory system processes signals. The eardrum’s abnormal position due to pressure imbalance can also contribute to these phantom sounds.

For most people, the ringing subsides as the pressure equalizes and the ear returns to normal function. However, the tinnitus may linger for hours or even days after the flight. If you experience persistent tinnitus that doesn’t improve or is accompanied by severe pain or hearing loss, medical evaluation is recommended.

5. Dizziness or Vertigo

Some individuals experience dizziness or a sensation of spinning (vertigo) as a symptom of airplane ear. This occurs because the pressure changes can affect the vestibular system – the part of your inner ear responsible for balance and spatial orientation.

The dizziness may be mild, causing slight unsteadiness, or more severe, leading to significant balance problems and nausea. You might feel lightheaded, as if the room is spinning, or experience a sense of being off-balance when walking or standing.

This symptom is less common than ear pain or fullness but can be quite distressing when it occurs. The vertigo typically resolves once pressure is equalized, but in some cases, it may persist for several hours. If you experience severe or prolonged dizziness, especially if accompanied by other concerning symptoms, it’s important to seek medical attention to ensure there’s no damage to the inner ear structures.

6. Ear Bleeding or Fluid Discharge

In more severe cases of airplane ear, the pressure differential can be great enough to cause the eardrum to rupture or tear, leading to bleeding or fluid discharge from the ear. This is a less common but more serious symptom that requires immediate medical attention.

The fluid or blood may be minimal – just a few drops – or more substantial, depending on the extent of the damage. You might notice a sudden decrease in pain when the eardrum ruptures, as the pressure is suddenly released. However, this relief is temporary and should not be mistaken for improvement.

A ruptured eardrum increases the risk of ear infection and can lead to more significant hearing problems if not properly managed. If you notice any blood or fluid draining from your ear after a flight, it’s crucial to see a healthcare provider promptly. While most ruptured eardrums heal on their own within a few weeks, they require monitoring and proper care to prevent complications.

7. Severe Ear Pain with Inability to Equalize Pressure

While mild ear discomfort is common with airplane ear, some people experience severe, intense pain that doesn’t respond to typical pressure-equalizing techniques like yawning, swallowing, or the Valsalva maneuver (gently blowing while pinching your nose closed). This more severe form indicates that the eustachian tubes are significantly blocked or that the pressure difference has become too great to resolve easily.

This severe pain can be sharp, stabbing, or throbbing in nature and may radiate to the jaw, neck, or head. It can be debilitating enough to cause distress, anxiety, and difficulty concentrating. Some people also experience headaches along with the severe ear pain.

Severe pain that persists for more than a few hours after landing, or pain that worsens rather than improves, warrants medical evaluation. This is especially true if accompanied by fever, significant hearing loss, or drainage from the ear, as these could indicate complications such as infection or eardrum perforation. People with pre-existing ear conditions, chronic sinusitis, or recent upper respiratory infections are more likely to experience this more severe form of airplane ear.

Main Causes of Airplane Ear

Understanding the causes of airplane ear can help you better prevent and manage this condition. The primary causes include:

• Rapid Altitude Changes: The most common cause is the rapid change in altitude during takeoff and especially landing. As the plane descends, the air pressure in the cabin increases faster than the pressure in your middle ear can equalize, creating an imbalance.
• Eustachian Tube Dysfunction: The eustachian tube connects the middle ear to the back of the throat and is responsible for equalizing pressure. If this tube is blocked, swollen, or not functioning properly, pressure equalization becomes difficult or impossible.
• Upper Respiratory Infections: Colds, flu, sinus infections, and other respiratory illnesses cause inflammation and mucus buildup that can block the eustachian tubes, making pressure equalization much more difficult during flight.
• Allergies: Seasonal or environmental allergies can cause inflammation and swelling in the nasal passages and eustachian tubes, creating similar blockage issues as respiratory infections.
• Small or Narrow Eustachian Tubes: Some people naturally have narrower eustachian tubes, which makes them more susceptible to airplane ear. This is particularly common in children, whose tubes are smaller and positioned more horizontally than in adults.
• Sleeping During Descent: When you’re asleep, you swallow less frequently, which means the eustachian tubes open less often. This reduces your body’s natural ability to equalize pressure during the critical descent phase of flight.
• Chronic Ear or Sinus Conditions: People with chronic sinusitis, ear infections, or structural abnormalities in the ear or nasal passages are more prone to developing airplane ear.

Prevention Tips

While airplane ear cannot always be completely prevented, there are several strategies you can use to minimize your risk and reduce the severity of symptoms:

• Stay Awake During Descent: Try to remain awake during takeoff and especially during landing. This allows you to actively work on equalizing pressure through yawning, swallowing, or other techniques.
• Swallow Frequently: Chewing gum, sucking on hard candy, or drinking water during altitude changes encourages frequent swallowing, which helps open the eustachian tubes and equalize pressure. This is particularly effective for children who can safely chew gum or suck on candy.
• Yawn Deliberately: Yawning naturally opens the eustachian tubes. During takeoff and landing, try to yawn several times to help equalize pressure.
• Use the Valsalva Maneuver: Gently pinch your nostrils closed, close your mouth, and gently blow as if trying to blow your nose. You should feel your ears “pop” as pressure equalizes. Be gentle – forceful blowing can damage your eardrums.
• Use Filtered Earplugs: Special pressure-regulating earplugs designed for air travel can help slow the rate of pressure change on your eardrums, giving your eustachian tubes more time to adjust.
• Avoid Flying When Sick: If possible, postpone air travel when you have a cold, sinus infection, or active allergy symptoms. The inflammation and congestion significantly increase your risk of severe airplane ear.
• Use Decongestants Before Flying: If you must fly while congested, consider using a nasal decongestant spray or oral decongestant before the flight. However, consult with a healthcare provider before using these medications, especially if you have high blood pressure, heart disease, or other medical conditions.
• Stay Hydrated: Drinking plenty of water before and during the flight helps keep mucous membranes moist and can improve eustachian tube function.
• Try the Toynbee Maneuver: Pinch your nose closed and swallow at the same time. This can be more effective than swallowing alone for some people.
• Feed Infants During Descent: For babies and young children, nursing or bottle-feeding during takeoff and landing encourages swallowing and can help prevent airplane ear.

Frequently Asked Questions

How long does airplane ear last?

Most cases of airplane ear resolve within a few hours after landing. In some cases, symptoms may persist for 1-2 days. If symptoms last longer than 48 hours or worsen, you should consult a healthcare provider.

Can airplane ear cause permanent hearing loss?

Permanent hearing loss from airplane ear is rare. Most cases result in temporary hearing changes that resolve once pressure equalizes. However, severe cases involving eardrum rupture or repeated trauma could potentially lead to lasting damage, which is why persistent symptoms should be evaluated by a medical professional.

How do you pop ears after a flight?

To pop your ears after a flight, try yawning, swallowing, chewing gum, or performing the Valsalva maneuver (gently blowing with your nose pinched and mouth closed). You can also try the Toynbee maneuver (swallowing while pinching your nose) or simply wiggling your jaw. If these don’t work within a few hours, applying warm compresses to the ears may help.

Is it safe to fly with a cold or sinus infection?

While not dangerous in most cases, flying with a cold or sinus infection significantly increases your risk of developing painful airplane ear and potential complications. If you must fly while sick, use decongestants before the flight and be diligent about pressure equalization techniques during altitude changes.

Can children get airplane ear?

Yes, children are actually more susceptible to airplane ear than adults because their eustachian tubes are smaller, narrower, and positioned more horizontally, making pressure equalization more difficult. Encouraging children to drink, chew gum (if age-appropriate), or suck on candy during takeoff and landing can help prevent symptoms.

When should I see a doctor for airplane ear?

Seek medical attention if symptoms persist for more than 2-3 days, if you experience severe pain, if there’s bleeding or discharge from the ear, if you have significant hearing loss that doesn’t improve, or if you develop fever, which could indicate an infection. These signs suggest complications that may require professional treatment.

Can airplane ear happen during other activities?

Yes, the same type of barotrauma can occur during other activities that involve rapid pressure changes, such as scuba diving, mountain climbing, driving through mountain passes, or even riding in fast elevators. Any situation where ambient pressure changes faster than your eustachian tubes can equalize can cause similar symptoms.

References:

• Mayo Clinic – Airplane Ear
• Healthline – Ear Barotrauma
• WebMD – Airplane Ear
• MedlinePlus – Ear Barotrauma
• NHS – Ear Problems