Ear Pressure Problems

People often complain about ear barotrauma or ear pressure problems. Pressure inside the ear is necessary for the ear to function well. Abnormal ear pressure can affect the hearing capacity. Normally, air pressure inside the ear and outside it are almost equal. Fluctuating levels of air pressure in the ear can lead to a feeling of discomfort, temporary hearing problem, and ear pain.

Although different parts of the human ear work together and promote proper functioning of the ear, the Eustachian tube/auditory tube that connects the middle ear, nose, and throat plays an important role in maintaining the pressure in the ear.

This tube ventilates the middle ear space, ensuring that the pressure in the ear almost equals the normal surrounding air pressure. The tube also helps in draining the accumulated secretions, infection, or debris from the middle ear space.

When the auditory tube is blocked, normal air exchange in the ear is disturbed which leads to building up of pressure in the middle ear portion. Dysfunction of the Eustachian tube is the main cause of ear barotrauma.

• Excessively small Eustachian tubes can afflict children with Down syndrome.
• Allergies can cause the tissue lining of the auditory tube to swell.
• The most common cause is common cold (respiratory infection).

• Smoking can damage the cilia that take away mucus and debris from the middle ear to the back of the nose.
• Masses or tumors in the skull base or nasopharynx can result in Eustachian tube obstruction.

• Children are more likely to experience ear pain due to fluctuations in ear pressure when compared to adults, as their tubes are narrower, more horizontal, and closer to the adenoids at the nasal openings.
• An enlarged adenoid can obstruct the opening of the auditory tube and so adenoid removal (adenoidectomy) is frequently recommended in children with chronic ear infections.

• An infection, allergy, or circulatory disturbances may agitate the fluid pressure in the inner ear chamber. This can lead to changes in the inner ear fluid as well as in the encasing membranes of the inner ear.

• Sinus infection causing stuffy nose can lead to stuffy ears. Generally, fluctuations in ear pressure levels caused by sinus lead to a pain in the ear, ranging from sharp, stabbing pain, to a low-grade chronic pain. Patients may feel as though the ear is full of liquid.

A blockage in the sinus passages and an increase in mucus production, both are responsible for this feeling. Ear popping can also be experienced, and it can sometimes be a painful symptom of ear barotrauma due to sinus infection.

• Intermittent ear fullness
• Ear popping or cracking
• Mild hearing loss
• Tinnitus (Ringing in the ears)
• Occasionally losing the balance of the body.
• Moderate to severe ear pain

The auditory tube plays an important role in equalizing air pressure across the eardrums during a rapid change in altitude. If the tube is healthy, it will open frequently and widely to equalize the changes in air pressure. When an airplane descends, air pressure increases. The change in air pressure pushes the eardrum inwards (retraction).

This is the time when a person with Eustachian tube blockage experiences fullness of the ear, dulled hearing, and/or ear pain. Some people experience similar symptoms when riding elevators, driving through the mountains, or diving to the bottom of a swimming pool. Scuba divers are particularly taught the techniques of equalizing the pressure in the ear.

• Passengers in a plane often experience ear pain while flying. Those who have Eustachian tube problems can use a decongestant pill or nasal spray an hour before the takeoff, and if required, prior to the descent.
• The decongestant helps in shrinking the membranes lining the nose and throat, which in turn allows the ears to equalize the pressure more easily.

• Those who experience chronic daily problems with auditory tube dysfunction can opt for an aggressive allergy control with the help of antihistamines, decongestants, and prescription nasal sprays.
• In severe but rare situations, a 'pressure equalization tube' (PET) is surgically placed in the eardrum, which ensures equalization of middle ear pressure.

Severe pressure fluctuations can make a person dizzy. Some people are more sensitive to the ups/downs of barometric pressure. It seems that there is an interaction between barometric pressure, migraine, and inner ear disturbance.

You should consult your doctor for a treatment plan if you often experience ear barotrauma. The doctor will detect the root cause of the ear pain. If there is an infection in the ear, antibiotics are prescribed as they help fight the infection. For quick ear barotrauma relief, you may try decongestants at home. A warm compress can help in relieving the pain. Keep your head in an elevated position while sleeping, and drink plenty of fluids. Remember that pressure sensitivity is a symptom and not a disease.

Disclaimer: This story is for informative purposes only and should not be used as a replacement for expert medical advice.