Ears Plugged and Unplugged: Why So?

In order to understand what’s happening in the ear, it’s important to learn its parts.

Normally, the middle ear (which is generally filled with air) uses the Eustachian tube to balance the pressures on either side of the ear. This tube is closed when at rest, but opens within a fraction of a second when a person swallows or yawns. At that point, the air remains in the middle ear and replaces air that has been absorbed by the mucus membranes or maintains pressure as needed. However, a malfunctioning Eustachian tube can cause problems in the middle ear. For example, if it is blocked, it will decrease the pressure in the middle ear and cause the eardrum to contract. In adults, this can cause a feeling of pressure, plugging, discomfort, hearing loss or a bussing sound.

The same thing happens during a flight. When the plane begins its descent, the air pressure in the ear drops below the pressure outside. This creates a vacuum, drawing the eardrum inwards and creating discomfort or a plugged feeling. Generally, the discomfort caused by flying is only temporary. However, if a person is suffering from nasal congestion, their Eustachian tubes may become blocked. This prevents the pressures from balancing properly, causing greater discomfort during landing.

Chewing gum, yawning more often, exaggerating jaw movements and swallowing can all help the Eustachian tubes open. If you do not have a cold or flu, you can also blow air into your ears using the Valsalva manoeuver. To do so, breathe in, close your mouth, puff out your cheeks, pinch your nose, then blow out slowly. If possible, avoid sleeping during landing. The reason for this is simple: when we sleep, we don’t swallow as often. To help a child who is too young to chew gum, give them something to drink so that they swallow.

For people older than 6 who regularly suffer from serous otitis, Eustachian tube rehabilitation and certain exercises may be prescribed as a preventive measure. These exercises are designed to reinforce the muscles of the Eustachian tube. Here is an example: moving the jaw from right to left in an exaggerated manner.

Depending on the degree of serous otitis, a tympanostomy tube may be necessary. This tube is placed through the eardrum to help aerate the middle ear when the Eustachian tube is not performing properly. It allows liquid to run out and the pressures to balance on either side of the eardrum. Note that if you need to fly when you have an upper respiratory infection, you can discuss various preventive treatments depending on your general health.