A few months ago, I had to travel forwork and found myself with some discomfort in my ears a few days before I was due to leave. I went to my doctor because I was concernced about flying. He told me that since I have been in so often with ear/sinus type complaints, that he was beginning to think that I have allergies. He prescribed Claritin along with an antibiotic and ibuprofen for the pain. During my flight out, I experienced some pain in the ears, however it was manageable. After several days away (while taking the prescibed medications), I flew home, and during both 2-hour flights I experienced what I can only term as excrutiating pain in both of my ears. I was quite sure that my ears were goung to burst! My ears continued to hurt for about 24 hours after the flight. I have to fly again in a few months, and I am beginning to dread getting on a plane. Is there anything that you can recommend, since obviously medication intended to help with sinus congestion did not seem to help the pressure in my ears.
Reply: -------------------------------
Most likely you experienced what is known as barotitis. This is a condition where there is a significant air pressure disturbance inside the middle ear during flying (or diving) that can result in fluid accumulation or actual bleeding. The condition often occurs when there is a pre-existent inflammation in the tissues of the upper airway tracts such as that which might occur with the common cold. Barotitis or middle ear pressure problems during airplane flight usually occur during descent when travelling from low pressure at high altitude to high pressure at low altitude. During descent the air pressure in the middle ear becomes lower than the ambient air pressure resulting in a vacuum effect. The effect is magnified with continued descent. Normally this air pressure disturbance is alleviated through the eustachian tube. Occasionally certain individual's eustachian tubes are not as efficient or the eustachian tubes may be inflamed because of an upper respiratory condition such as a cold, sinusitis, or allergy. Once barotitis occurs, antibiotic therapy and decongestants may be necessary and it may take a few days to a few weeks to completely eliminate the symptoms associated with the condition.
If one is prone to ear pressure problems during airplane flight, I recommend the use of oxymetazoline nasal spray such as Afrin immediately prior to flight and perhaps repeated prior to descent in long flights. (Remember not to use Afrin for more than 3 consecutive days). It may also be helpful to use a decongestant such as Sudafed before flight. Antihistamines such as Claritin will NOT be helpful in avoiding barotitis. Finally, chewing gum, drinking a beverage, and frequently "popping" one's ears during descent of the airplane are also recommended.
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Steve Dankle, MD
Otolaryngology-Head and Neck Surgery
Milwaukee, Wis
NOTICE: OFCN is not engaged in the rendering of professional medical services. The information contained on this system or any other OFCN system should not supplant individual professional consultation. It is offered exclusively as a community education service. Advice on individual problems must be obtained directly from a professional.
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