Understanding airplane ear: causes, symptoms & prevention

Airplane ear, also known as ear barotrauma, is a common condition that occurs when pressure changes around you affect the middle ear. It typically happens during air travel, particularly during take-off and landing, when the air pressure inside the cabin changes faster than your ears can adjust. These changes can cause discomfort, ear pain, or a temporary reduction in hearing.

Airplane ear is usually temporary and manageable, especially when you understand what’s happening and how to prevent it.

What is airplane ear (ear barotrauma)?

Airplane ear happens when there is an imbalance between the air pressure inside the middle ear and the air pressure outside the eardrum. The Eustachian tube - a small passage connecting the middle ear to the back of your nose and throat - normally equalises this pressure by opening and closing as you swallow or yawn. However, when it becomes blocked or cannot open properly, air pressure builds up behind the eardrum, causing it to stretch uncomfortably or even become damaged.

This pressure imbalance most often occurs:

· During air travel, especially take-off and landing when cabin pressure changes quickly

· While scuba diving, when descending or ascending in water

· When driving or hiking at high altitudes

If pressure cannot equalise, it may cause pain, muffled hearing, or in more severe cases, a small tear (perforation) in the eardrum. Though rare, severe barotrauma can lead to fluid leakage or temporary hearing loss.

What causes airplane ear?

The Eustachian tube plays a crucial role in maintaining pressure balance in your ears. When this tube doesn’t function properly, you are more likely to develop airplane ear. Common causes include:

· Colds, sinus infections, or allergies: These can cause swelling and congestion, making it harder for the Eustachian tube to open.

· Earwax build-up: Excess wax can trap air and interfere with pressure regulation.

· Rapid altitude changes: Flying, diving, or mountain travel can all create sudden pressure differences.

· Upper respiratory infections: Inflammation from infections can block airflow through the tube.

Sometimes, a combination of congestion and altitude changes can increase discomfort. If you already have an ear infection or fluid in the middle ear, airplane ear symptoms can be more noticeable.

Symptoms of airplane ear

Most people experience mild ear popping or pressure during flights. However, when pressure changes are extreme or the Eustachian tube is blocked, symptoms can be more uncomfortable. Common signs of airplane ear include:

· Ear pain or discomfort, often worse during descent

· Fullness or pressure in one or both ears

· Muffled hearing or a sensation of being underwater

· Popping or crackling sounds when swallowing or yawning

· Temporary hearing loss after landing

· Ringing or buzzing in the ear (tinnitus)

· In more severe cases, dizziness, nausea, or balance problems

Symptoms often ease as the pressure equalises. However, if they persist for more than a few hours or are accompanied by pain, discharge, or hearing loss, it could indicate barotrauma or another ear condition that requires attention.

How to prevent or relieve airplane ear

The best way to manage airplane ear is to help your Eustachian tubes stay open and functioning during pressure changes. Here are several effective ways to prevent or ease symptoms:

Before your flight:

· Avoid flying when you have a cold, sinus infection, or severe congestion. If possible, postpone travel until you’re feeling better.

· Use a decongestant spray or saline nasal rinse an hour before flying to clear nasal passages.

· Keep ears clean and free of wax build-up to allow pressure to equalise naturally.

During take-off and landing:

· Swallow, yawn, or chew gum regularly to encourage the Eustachian tube to open.

· Perform the Valsalva manoeuvre: Gently blow while pinching your nose and keeping your mouth closed. This helps push air into the middle ear to equalise pressure.

· Try filtered earplugs (flight earplugs) designed to slow the rate of pressure change.

· Stay awake during descent, as swallowing reflexes are reduced when sleeping.

For babies and children:

· Encourage feeding, sucking on a dummy, or drinking during take-off and landing to help equalise pressure naturally.

· If your child has a cold or infection, speak to a pharmacist or GP about suitable nasal drops before flying.

If discomfort persists after your flight, try swallowing, yawning, or gently performing the Valsalva manoeuvre again. Avoid inserting objects like cotton buds into your ears.

When to see a professional

Most cases of airplane ear clear up within a few hours, but you should see a hearing or ear care professional if you experience:

· Severe or persistent ear pain lasting more than 24-48 hours

· Hearing loss, tinnitus, or a feeling of fullness that does not improve

· Dizziness or balance problems after flying

· Fluid, blood, or discharge from the ear canal

These symptoms could be caused by barotrauma, infection, or a perforated eardrum. A professional examination ensures that you receive the right care quickly and safely.

At Leightons, our audiologists can examine your ears during a free hearing assessment using specialist equipment to check for wax, fluid, or infection. If necessary, we’ll refer you to an ENT specialist for further investigation or treatment.

How Leightons can help

At Leightons, we provide a range of services to help you maintain healthy, comfortable ears. Our ear health checks allow us to identify blockages, wax build-up, or signs of infection that could make you more prone to airplane ear.

Whether you’re a frequent flyer or simply want peace of mind before your next trip, our friendly audiologists can help you prevent discomfort and protect your hearing.

Book your free hearing assessment today and take the first step towards healthy, balanced ears.

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Mastoiditis is a rare but serious ear infection that affects the mastoid bone, which sits just behind the ear. It usually develops when a middle ear infection (otitis media) spreads to the mastoid bone, causing inflammation and fluid build-up. Although it sounds alarming, mastoiditis can be successfully treated with prompt medical care. At Leightons, we understand that ear pain and swelling can be worrying. Our audiologists are here to check your ear health, explain what’s happening, and help guide you to the right care if an infection is suspected. What is mastoiditis? The mastoid bone is part of your skull and contains small air-filled spaces that help drain the middle ear. When bacteria from an untreated or severe ear infection spread to this bone, it can become inflamed and filled with infected fluid. This condition is known as mastoiditis. If not treated quickly, the infection can cause pain, swelling, and in some cases, damage to nearby structures - which is why early diagnosis and medical treatment are essential. What causes mastoiditis? Mastoiditis most often develops as a complication of a middle ear infection that hasn’t fully cleared. When bacteria remain trapped in the middle ear, they can spread into the mastoid bone, causing inflammation and infection. Common causes and contributing factors include: Untreated or chronic ear infections Bacterial infection spreading from the middle ear Recurrent infections weakening ear tissues Poor ear drainage due to Eustachian Tube Dysfunction Mastoiditis can occur at any age but is more common in children, as their ear structures are still developing. Common symptoms of mastoiditis Mastoiditis symptoms can appear suddenly and may follow an ear infection that hasn’t fully resolved. Common signs include: Severe, persistent ear pain Swelling or redness behind the ear Ear discharge (sometimes thick or pus-like) Fever and feeling unwell Hearing loss in the affected ear Headache or dizziness In some cases, the ear may appear pushed forward due to swelling behind it. Because mastoiditis can worsen quickly, it’s important to seek medical attention if you notice these symptoms. How is mastoiditis diagnosed? A GP or ENT specialist can diagnose mastoiditis by examining the ear and checking for inflammation, swelling, or discharge. Tests may include: Otoscopy: Looking inside the ear to assess infection Hearing test (audiogram): Checking if hearing has been affected CT scan: To confirm if the infection has spread to the mastoid bone Blood tests: To detect signs of infection Early diagnosis allows for quicker treatment and prevents complications. Treatment for mastoiditis Treatment aims to remove the infection, relieve symptoms, and prevent further spread. Depending on the severity, this may involve: Antibiotics: Usually given intravenously (via a drip) to control the infection Ear drainage: A small procedure to remove infected fluid or pus Surgery (mastoidectomy): In more serious cases, part of the infected bone may be removed to stop the infection from spreading With prompt treatment, most people recover fully and experience no long-term hearing damage. Preventing mastoiditis The best way to prevent mastoiditis is by treating ear infections early and avoiding irritation to the ear canal. Simple steps include: Seek medical advice for any ear infection that lasts more than a few days Avoid inserting objects like cotton buds into your ears Keep ears dry and clean, especially after swimming Attend regular ear health checks to monitor your ear condition if you’re prone to infections By managing ear health proactively, you can reduce the risk of complications like mastoiditis. How Leightons can help At Leightons, we provide ear health checks and free hearing assessments to help identify infections early and support your recovery after treatment. Our audiologists can: Examine your ears safely for signs of infection or inflammation Carry out hearing tests to check for any hearing changes Refer you to an ENT specialist for medical treatment if necessary Offer aftercare and follow-up checks to monitor your ear health after recovery We’re here to help you understand your symptoms, protect your hearing, and feel confident in your ear health. Book your free hearing assessment today and take the first step toward clearer, healthier hearing.
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