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Ask Well Sometimes my ears hurt during flights


 

Ask Well

Sometimes my ears hurt during flights. Why does this happen, and what can I do about it?

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When you fly thousands of feet above ground, the changes in cabin pressure can be downright unpleasant, causing potential issues like abdominal bloating, headaches and yes, earaches.

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"Airplane ear" is an umbrella term for a variety of symptoms caused by rapid changes in altitude and air pressure, said Dr. David Gudis, an otolaryngologist at New York Presbyterian Columbia. For some people, the condition may, cause intense pain and even damage the ear drum.

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"The good news is that it generally resolves on its own," Dr. Gudis said. "It can just be very uncomfortable until it does." This can take anywhere from seconds to days, he added.

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In the space behind your eardrum, or the middle ear, is a structure called the Eustachian tube, which connects the middle ear to the back of the nose and throat. The Eustachian tube is responsible for keeping the air pressure between the middle ear and the environment the same.

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Keeping air pressure balanced is "something we don't normally have to think about," said Dr. Esther X. Vivas, a professor of otolaryngology at the Emory University School of Medicine in Atlanta. We can usually do it by yawning or swallowing, which contracts muscles that open the Eustachian tube, experts said.

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But when the air pressure changes quickly during a flight, it can be hard for the Eustachian tube to "keep up," Dr. Gudis said. This can make us feel that we need to yawn or "pop our ears" to force the tube open, said Dr. Gregory Levitin, an otolaryngologist at the Mount Sinai Health System in New York City

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If air can't pass through the Eustachian tube, the air pressure inside your ears won't be the same as the air pressure around you, Dr. Levitin said.

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The unequal pressure can stretch the ear drum and cause pain, experts said. It can also stifle hearing by preventing the ear drum from properly responding to sound waves.

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There are several explanations experts said, but the most cornmon culprit is having upper respiratory congestion before you fly.

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The middle ear and Eustachian tube have a mucous lining that traps and protects against harmful bacteria. But when you're congested from something like a cold, allergies or a sinus infection the lining may swell, which can clog the tube, said Dr. Howard W. Francis, a professor of otolaryngology at the Duke University School of Medicine.

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Flying with an ear infection car also increase your chances of experiencing rare yet severe and painful symptoms of airplane ear such as a ruptured ear drum, Dr. Francis said. If you have an ear ?infection and you're scheduled to fly, consider changing your travel plans if possible, Dr. Francis said.

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Airplane ear usually goes away once air can pass through the Eustachian tube - which can happen within seconds, minutes, hours or a few days of when your symptoms start, experts said.

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The quickest way to deal with it is to "pop your ears," Dr. Vivas said. Try forcing yourself to yawn, or chew gum or sip water to get yourself to swallow.

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If that doesn't work, Dr. Gudis said, try the Valsalva maneuver, a breathing technique that involves closing your mouth and pinching your nose while gently exhaling.

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Any symptoms that last for weeks, are extremely uncomfortable or that happen every time you fly should prompt a visit to an ear, nose and throat doctor, Dr. Gudis said.

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Katie Mogg

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