It has happened to all of us: a crowded flight and a crying
baby (or two or three). During the take-off and again during the descent
process, the poor baby fusses and cries, while the distraught parents feel
helpless and tense.
Why do babies fuss so much during these altitude changes? The
same reason your own ears pop during a flight--namely, the effect of air
pressure on your middle ear.
An ear is divided into three parts: (1) outer ear, (2) middle
ear, and (3) inner ear. The outer ear consists of the external part you see on
the side of your head and the ear canal which leads to the eardrum. The middle
ear refers to the eardrum itself, middle ear bones, and air pockets that are
behind the eardrum and in the mastoid cavities. The inner ear is the location of
the nerve endings for hearing and balance organs which are crucial to the body's
During airplane travel, your ears may be exposed to rapid
altitude or pressure changes. Because it is partially composed of an air pocket
inside your head, the middle ear is particularly vulnerable to these changes in
altitude and air pressure.
Ordinarily, your ears will "pop" frequently when you swallow.
This "popping" occurs when a small air bubble passes from the back of your nose
into your middle ear. The air bubble travels through the Eustachian tube, a thin
passage connecting the back of your nose with your middle ear, and is eventually
absorbed by the tube's lining. Swallowing and yawning more quickly replenishes
this air in your middle ear because these actions move the muscle that opens the
Eustachian tube. Swallowing and yawning thus help to equalize the air pressure
on both sides of your eardrum. Intentionally popping your ears (by
gently blowing while pinching your nostrils) can also help.
In order to maintain ear comfort, your Eustachian tube must
be able to open widely and frequently enough to adjust to air pressure changes.
If the air pressure in your eardrum is not equal, your ears can feel blocked.
This can occur for a number of reasons. Quick changes in altitude or
pressure--such as in airplanes, elevators, or deep sea diving--make it more
difficult for the Eustachian tube to do its job. Your Eustachian tube can also
be blocked, and thus prevent equalization of your middle ear pressure, when you
are suffering from an ordinary cold, nasal allergies, a middle ear infection,
and/or a sinus infection.
Because children have particularly narrow Eustachian tubes,
they are even more susceptible to blockages than adults. Babies and other young
children obviously may not understand they need to swallow on take-off and
landing during a flight, thus exacerbating the problem for them. Similarly, they
cannot intentionally pop their ears. Parents can help alleviate their children's
discomfort, however, by keeping them awake during altitude/pressure changes and
encouraging them to suck on a bottle or pacifier.
- If you have had recent ear surgery, you should
consult your physician prior to flying.
- Persons who have ever had ear surgery or those with a
history of infections may wish to consult their physicians prior to
snorkeling or scuba diving. There are also specific, important
guidelines for flying after diving. Find out before you dive or
- It is best to avoid flying if you are currently
suffering from a cold, allergies, or sinus or middle ear
- Over the counter decongestants (in the form of a pill
or nasal spray) can alleviate ear fullness sensation caused by flight.
Medication should be taken approximately one hour prior to the plane's
descent. Pregnant women and those who suffer from heart disease or
irregular heart rhythms, high blood pressure, thyroid problems, or
nervousness should consult their physicians prior to using such
- Unless otherwise specifically ordered by your doctor,
over the counter nose sprays should be used for no more than a few days.
Typically, after 3 days of use, the same nose sprays which were so
helpful initially may actually cause your congestion to worsen.
- If you continue to have ear fullness sensation and/or
pain after your flight, see your doctor. You may have fluid in your ear
or an infection requiring
Hector N. Hernandez,
Assignment Accepted - New Patients Welcome
Boulevard Port Charlotte, Florida 33952
© 2004 AAO-HNS/AAO-HNSF
Please read our disclaimer. Any information provided on this Web site should not be considered medical advice or a substitute for a consultation with Dr. Hector N. Hernandez or other healthcare professional. If you have a medical problem, contact us for diagnosis and treatment.