If you’ve ever been on a plane, in a fast elevator or dived underwater, you’ll know that pressure in your ears. The feeling that starts in your ear, travels below your eyes until finally something “pops” and you get relief. Mostly we do this without even thinking about it, but have you ever wondered why you get that feeling? Or what would happen if it didn’t just “pop”?
As you probably already know, your ears, nose and throat are all interconnected. Going from your middle ear, under your eyes and to the back of the nose is the “Eustachian tube”. This tube serves to regulate the pressure between your middle ear and the outside environment. Normally, it stays closed and the pressure is the same inside and outside of your head. But changes in the air pressure can make the tube need to start opening to normalise your middle ear. Things like the descent in a plane, riding an elevator quickly, diving underwater or mountain driving can be factors.
When the air pressure is suddenly modified, you feel the change as that pressure on your middle ear. This is the stage where the Eustachian tubes need to be opened to equalise the pressure. You can do this by yawning, swallowing or chewing, until you feel a click, and feel the pressure normalise. On a plane, for example, it’s a good idea to chew gum or have a hard candy to suck on. This will help you open those tubes subconsciously and avoid the pressure – and pain – that come with the change. If these fail, pinch your nose, close your mouth and try to blow air out to force the tubes open. This is particularly useful when scuba diving, stopping regularly during your descent/ascent.
If you don’t successfully “pop your ears” with the pressure changes, things can start to get troublesome. As the pressure outside continues to increase, the air inside the closed tubes starts to get absorbed. This creates a vacuum which in turn sucks the eardrum inwards, stretching it – you can see where this is going… At this point, you will feel everything is muffled or blocked, and it can be painful. Should this continue, your ear membrane can start developing fluid in the ear to try to overcome the vacuum. Keep it up long enough and you run the risk of rupturing an eardrum.
Sometimes you may struggle with blocked Eustachian tubes not being able to open. If you’ve ever been on a plane with a bad cold, you’ll know the discomfort that can bring on! Causes can include nasal allergies, a bad cold or sinusitis, even a wax blockage. It is important to note also that children have narrower Eustachian tubes than adults, and babies cannot open theirs. So what do you do in these situations?
If your blockage comes from cold or flu symptoms, try using relief medication or nasal spray to decongest. If it’s allergies, make sure you have a good antihistamine with you in situations where pressure changes can occur. Wax blockage can be treated with wax removal drops or a wax removal done by your audiologist or GP. For children, give them hard candy to suck on during a plane descent. Babies should not sleep during landing, and you can use a pacifier or feed them to force the swallowing.
Regular travellers who struggle with Eustachian tube blockages should consider getting travel earplugs. These will help reduce the pressure on your ears and prevent complications from coming up. Make sure you see your audiologist if the pressure in your ears does not equalise after a flight or dive.