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1 Flying and the ear

2 Flying and the ear This factsheet is part of our Ears and ear problems range. It is written for people with hearing loss, which refers to people who are deaf, deafened or hard of hearing. Read this factsheet to find out: What are the effects of flying on the ears and hearing? Why does flying sometimes cause ear pain or discomfort? How does flying affect the inner ear? How can I reduce the effects of flying on my ears? Can flying make tinnitus worse? Will flying affect my ears if I have grommets? Can I fly after ear surgery? What can I do if I feel anxious about flying? Where can I get further information? If you would like this factsheet on audio tape, in Braille or in large print, please contact our helpline see front page for contact details. What are the effects of flying on the ears and hearing? Many people with hearing loss or tinnitus find that flying can cause pain, discomfort in their ears or temporary hearing loss. These side effects usually only continue while you are flying and your ears should get back to their normal state a short time following landing. Why does flying sometimes cause pain or discomfort in the ears? Flying can create a difference between air pressure in the part of your ear called the middle ear and the atmospheric pressure of the plane. This is what can cause pain, discomfort or temporary hearing loss during a flight. The space in the middle ear, which is behind your eardrum, is normally filled with air at the same pressure as the surrounding air. Air reaches the middle ear through the eustachian tube, which connects the middle ear to the back of the nose and throat. The eustachian tube is closed for 95% of the time and only opens when you swallow or yawn. When this happens, the air pressure on either side of the eardrum evens out. Flying and the ear, Action on Hearing Loss Information, November

3 After take-off, the pressure in the plane slowly drops. Usually, this does not cause a problem as the air in the middle ear is at a relatively high pressure and gets blown down the eustachian tube. You are most likely to feel pain or discomfort, or experience hearing loss, when the plane comes down to land. During landing, the air in the middle ear is at a lower pressure than that in the plane. The eustachian tube may become blocked and the small muscles in the throat may not be able to open it. The resulting low pressure in the middle ear causes the eardrum to press inward, causing discomfort or pain, and temporary hearing loss. This small temporary reduction in your hearing may make a huge difference in your ability to understand speech if you already have hearing loss. However, eustachian tube blockage usually clears up by itself after a short time. How does flying affect the inner ear? Very occasionally, sudden decompression a drop in air pressure occurs in the plane. This can affect the inner ear, our organ of hearing which detects sound, and cause a sudden disturbance in your balance and hearing. This is extremely rare, but if it does happen go to the accident and emergency department of the nearest hospital as quickly as possible after landing to check for any damage and to get treatment. If you develop any ear problems or conditions during or following a flight which do not clear up after a few hours, you should see your GP. How can I reduce the effects of flying on my ears? You can do a number of things to reduce the effects of flying on your ears. Most of these help to help keep your eustachian tube open: The eustachian tube does not open well when you are sleeping. Make sure you are awake before the plane begins its descent, which may start up to an hour before it lands. Yawn, chew gum or suck on a hard sweet to encourage your eustachian tube to open. Keep swallowing water or another drink (not alcohol). Do this every 15 to 30 seconds if you need to. If this does not help, try the Valsalva manoeuvre. Pinch your nose between your finger and thumb, and gently blow air down it with your mouth closed, without releasing the air. If you hear or feel air going into your ears, your eustachian tube is working well. Make sure you are not dehydrated and that you have had plenty to drink. Do not drink alcohol. Flying and the ear, Action on Hearing Loss Information, November

4 Flying may be uncomfortable if you have a cold or other infection around the nose and throat. This can make the lining of the eustachian tube swollen so it gets blocked more easily. If you must travel, ask your GP or pharmacist for advice about decongestants to reduce inflammation and relieve the blocked sensation. Many GPs recommend you use a decongestant spray about 20 minutes before you land. It is important not to use the spray for more than five days continuously. Some people find that earplugs called TravelFit, which are designed for flying, have helped with ear discomfort. TravelFit slow down the pressure changes within your ear. Using ordinary soft earplugs is not recommended. You can buy TravelFit earplugs from our shop see the front page for contact details or try your high-street pharmacy. Can flying make tinnitus worse? If you have tinnitus, you may find flying is the one time when you are usually completely free of tinnitus because of the noise made by the engines and airflow around the plane. However, if your eustachian tubes are blocked, your tinnitus may seem temporarily louder. It should return to its previous level when your eustachian tubes become unblocked. If you have tinnitus and hearing loss, you will find that it is often the straining to hear that makes your tinnitus louder when on a plane. If you normally wear hearing aids, you should keep them on during your flight as removing them may make your tinnitus louder and more noticeable. Being anxious about flying may make your tinnitus worse. Basic relaxation exercises during the flight may help you. See our factsheet, Tinnitus, sleep and complementary therapies. Very rarely, the sound of plane engines can make your tinnitus worse. If you are worried about the noise of the plane engines, book ahead and try to get a seat near the front of the plane, away from the engines. Will flying affect my ears if I have grommets? Flying is less likely to cause discomfort in a child or adult with grommets in their ear. A grommet allows air in and out of the ear, reducing the stress on the eardrum caused by changes in air pressure in the plane. However, children who have a history of frequent ear infections or have had grommets in the past (but no longer have them) are occasionally at risk of perforation of the eardrum when flying. If you are worried about this, ask your GP. Flying and the ear, Action on Hearing Loss Information, November

5 If you have perforated eardrums as a result of infection or injury, flying is also less likely to cause discomfort. This is because any change in pressure can even out across the eardrum and does not depend on the eustachian tube working normally. Can I fly after ear surgery? If you have any kind of ear surgery, always check first with your ear, nose and throat (ENT) consultant when it would be safe for you to fly. What can I do if I feel anxious about flying? If you are anxious about the effects of flying on your ears or about flying generally, talk to your GP. Very rarely, they may prescribe tranquillisers. Relaxation and breathing exercises can also be helpful for anxiety in general. If your only worry is that flying may be harmful to your ears, in almost all cases you can go ahead and enjoy your flight. If your reason for flying is to take a holiday, you have something enjoyable and relaxing to look forward to! Where can I get further information? Our helpline offers a wide range of information on many aspects of hearing loss. You can contact us for further copies of this factsheet and our full range of factsheets and leaflets see the cover page for contact details. Action on Hearing Loss Information, November 2010 The Royal National Institute for Deaf People. Registered Office: Featherstone Street, London EC1Y 8SL. A company limited by guarantee registered in England and Wales No , Registered Charity Numbers (England and Wales) and SC (Scotland). Flying and the ear, Action on Hearing Loss Information, November

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