What is ear barotrauma (airplane ear)?

Ear barotrauma is the most common form of barotrauma and refers to damage to your ears that can happen if there’s a sudden change in air pressure or water pressure that affects your middle ear.

Many people refer to it as “aeroplane ear” because it often occurs while flying, but you can also develop ear barotrauma from diving down to the bottom of a swimming pool or scuba diving.

What causes ear barotrauma?

Ear barotrauma happens when air or water pressure suddenly changes, putting pressure on your eustachian tubes. Your eustachian tubes are small tubes that connect your middle ears to the back of your throat. Their main functions are to drain fluid from your middle ears and balance air pressure on both sides of your eardrums. This is achieved by opening when you swallow or yawn, allowing small amounts of air to enter so that the pressure in your middle ear matches the air pressure around you.

Usually, if you experience a sudden change in air pressure, such as during takeoff and landing or diving, your eustachian tubes will equalise and rebalance the pressure. However, if they can’t open fast enough, pressure can build up behind your eardrum and make your ears feel blocked or full, cause popping or crackling sounds, affect your hearing, or lead to sharp pain or tinnitus.

What are the risks of ear barotrauma?

In general, ear barotrauma is a temporary issue that goes away with self-care or when air and water pressure changes stop. However, in rare cases, it can lead to a ruptured eardrum, so you should call your GP or audiologist as soon as possible if you experience:

• Hearing loss
• Ringing in your ears (tinnitus)
• Discharge from your ears
• Nausea from a spinning sensation (vertigo)

How is ear barotrauma diagnosed?

A healthcare provider will:

• Take note of your symptoms and how long you’ve had them
• Check your ear with an otoscope. This is a special lighted instrument that lets us look inside your ear to see what’s going on.
• Refer you to your local audiologist for a hearing assessment if needed.

How is ear barotrauma treated?

Treatment varies depending on your situation. Your treatment may include:

• Decongestants to help with congestion
• Corticosteroids to reduce inflammation
• If you have a ruptured eardrum, you may need tympanoplasty to close the hole in your eardrum.

Eustachian tube dysfunction can be caused by inflammation, mucus buildup, or structural issues. Most of the time, these issues resolve on their own. However, if ear pressure, pain, or blocked hearing lasts more than a few days, keeps coming back, or is affecting your hearing or balance, seeing an audiologist is recommended. They will do a hearing test and make the necessary referral, where applicable.