Barotitis Media (Airplane Ear)

Barotitis Media

Barotitis media, also known as ear squeeze or airplane ear is an inflammation or injury on your eardrum or other tissues of the middle ear. It usually results from an imbalance of the normal air pressure in the ear and the air pressure of the atmosphere that is brought about by many factors such as changes in the altitude, in diving and in hyperbaric chambers.

Barotitis media occurs due to a blockage in the Eustachian tube. Such blockage traps air moving in and out of the ear. Thus, increasing the air pressure that results to swelling of the tissues and blood vessels that line the middle ear. Usually self-care techniques such as yawning, swallowing or chewing gum  can prevent or correct the differences in air pressure and improve symptoms.

Symptoms of barotitis media usually goes away on its own and requires no medical treatment. However, some cases may become so severe that it requires prompt medical attention.

Causes

Barotitis media happens when you go through things that cause sudden changes in altitude (height). Any of the following may cause barotitis media:

• Being in an airplane that lands too fast
• Scuba diving
• Falling fast while skydiving
• Hyperbaric chambers
• Sudden nearby explosions

Signs and symptoms

Barotitis media can occur in either one or both ears. Symptoms can range from mild to severe. Symptoms can cause discomforts for a few hours or may last longer. The symptoms of barotitis media include:

• Ear pain
• Fullness or stuffiness in the ear
• Muffled hearing or slight to moderate hearing loss

Severe symptoms can occur that tend to last longer than expected. These symptoms include:

• Severe pain
• Feeling of pressure in your ear similar to being underwater
• Moderate to severe hearing loss
• Ringing in your ear (tinnitus)
• Spinning sensation (vertigo)
• Vomiting resulting from vertigo
• Bleeding from your ear

Test and Diagnosis

The doctor will likely ask about your recent activity such as air travel or scuba diving. It is also important to inform your doctor about the medications that you have been taking. An otoscope will also be used to look at the eardrum and middle ear. Barotitis media usually presents a slight outward or inward bulging of the eardrum. In severe cases, pooling of blood or other fluids may be seen behind the eardrum.

Treatment

Barotitis media usually heals on its own without the need for treatment. When the symptoms persist, treatment is required and is aimed at equalizing the pressure inside the ear to relieve pressure.

Medications

• Inflammation is usually managed with non-steroidal anti-inflammatory drugs such as ibuprofen
• Pain relievers are also prescribed such as acetaminophen
• Decongestant nasal sprays to keep the Eustachian tube to function well and ease discomforts

Although rare, surgical management called myringotomy can be done by making incision in the air drum to equalize pressure.

Self-care Therapy

The doctor will also instruct you to perform Valsalva maneuver to help your ears to open up and release the pressure. It is done by pinching your nose, closing your mouth and gently pushing the air out as if blowing your nose.

Prevention

To prevent airplane ear, try the following techniques:

• Yawn or swallow during the ascent or descent of the plane
• Avoid sleeping during takeoff and landing
• Try the Valsalva method by blowing through your nose while pinching your nostrils and your mouth closes  during the ascent and descent
• Take OTC decongestant nasal spray
• In case of an allergy, take medication one hour before the flight
• Use earplugs

References

https://www.mayoclinic.org/diseases-conditions/airplane-ear

https://www.healthcommunities.com/ear-infections/what-is-airplane-ears.shtml