Do you often experience ear pain when flying? How to prevent?

Many of us have experienced discomfort and even pain in the ears when flying, especially when taking off or landing. This condition is called aerotitis. Aerotitis occurs due to changes in air pressure in the environment which causes changes in gas volume and pressure which then presses in all directions in the middle ear cavity and results in trauma and inflammation. Symptoms can include a feeling of fullness and discomfort in the ears, pain, ringing in the ears, vertigo, or in some severe cases can cause bleeding and permanent hearing loss.

Normally there is a channel, namely the eustachian tube, which connects the middle ear cavity to the nasopharyngeal cavity. One of the functions of this channel is to help maintain a balance between the pressure in the middle ear cavity and the external environment. The eustachian tube can open automatically (including during flight due to changes in air pressure), or can be triggered when someone swallows or yawns. But there are several conditions that interfere with this normal process and increase the risk of aerotitis.

Risk Factors for Aerotitis:

  1.     Babies and young children are associated with a smaller eustachian tube shape.
  2.     There are abnormalities in the body such as nasal polyps, deviated nasal septum, and others.
  3.     Currently experiencing an infection of the middle ear canal such as acute otitis media
  4.     Currently experiencing infections of the upper respiratory tract such as common cold, influenza, rhinitis, and others.
  5.     Have a history of allergies with manifestation of symptoms in the upper respiratory tract such as allergic rhinitis.
  6.     Fall asleep when the plane takes off or lands.

These conditions can increase the risk of aerotitis because they can cause the eustachian tube to not work optimally and there is a failure to balance the air pressure between the middle ear cavity and the external environment.

How to Prevent and Treat Aerotitis Conditions:
- Try to be awake during takeoff and landing.
- Make swallowing, chewing or yawning movements, especially during takeoff and landing.
- Do not fly when you have a respiratory tract infection or ear infection if it is not urgent.
- Allergy control for people who have a history of allergies, especially allergic rhinitis, if necessary, allergy medication can be taken approximately 1 hour before the plane takes off.
- Perform the Toynbee maneuver by pressing your nose while closing your mouth, then make a swallowing movement. This maneuver works in a similar way to the Valsalva maneuver, but is safer because the risk of damage to the eardrum is lower.
- If necessary, you can use decongestant drugs which are sold freely in drug stores or pharmacies

If the complaint persists or does not decrease or you are not fit when you are about to fly, don't hesitate to immediately consult a doctor for a more complete examination so that further management can be carried out.

The following is a brief explanation about aerotitis. This condition often occurs in many people and is often considered normal. However, aerotitis actually not only causes discomfort but also has serious complications if left untreated.

Article written by dr. Andyka Banyu Sutrisno, Sp.KP (Aviation Medicine Specialist at EMC Cibitung Hospital).