Ear and Sinus Trouble While Flying
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Ear and Sinus Trouble While Flying

Ears and sinuses can become painfully blocked during air travel. Follow these suggestions to better understand, prevent and manage these conditions.

The air pressure changes that occur during air travel can cause injury to ears or sinuses called barotrauma. During the ascent of a flight the cabin pressure falls. In pressurized aircraft at cruising altitude the cabin pressure is similar to being on a mountain at 6000-8000 feet. At these lower pressures, air in the sinuses and middle ears expand. Usually it can freely escape out the Eustachian tube (middle ear vent tube) and the openings of the sinuses in the nose. During aircraft descent the rising cabin pressures cause air in the sinuses and middle ear to contract. Air needs to flow into the middle ear and sinus openings to avoid a vacuum effect.

With ear and sinus infections, a cold, or allergies the Eustachian tube and sinus openings may become swollen and blocked. This can lead to severe ear or sinus pain; pull in fluid and blood, or less commonly, eardrum or sinus rupture. This can be avoided by preventing blockages when a cold or allergies are present. Decongestants taken prior to the fight and if needed during the flight may reduce the risk of pain or rupture. Pseudoephedrine tablets and oxymetazalone nasal sprays are good choices of decongestants, but should only be used for a short time. Swelling can be reduced with the use of full strength gargles containing phenol. If needed, all these treatments can be taken together for optimal effect.

If you are having difficulty clearing plugged ears during takeoff, open your mouth and move your jaw, or swallow. During landing try drinking fluids or chewing gum. In addition you may pinch your nose, close your mouth, and attempt to blow your nose using a quick sharp blast. This technique is called the Valsalva maneuver and is used often by divers and military pilots. This method may provide immediate relief. There is a product on the market called "Ear Planes." These are plugs that fit into your ear canals and allow the pressure changes to take place more slowly. The slowing of the rate of pressure change minimizes the difference in pressure across the ear drum and may give you extra time to fully clear your ears. Try to stay ahead of the change in pressure by using these techniques before the ear fullness becomes painful. If you know you have this difficulty, see your physician for advice and guided instruction before you travel.

Did you ever hear children suddenly start crying during the landing phase of your flight? Many have ear pain. Infants and small children often have more difficulty equalizing their ears than adults. It is thought that this may be because their Eustachian tubes are “S” shaped and can be blocked more readily. As the head grows the Eustachian tubes tend to straighten out. Before aircraft descent, awaken infants and small children and have them drink some fluids until landing. The swallowing helps keep their middle ears equalized.

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