What is barotrauma?
Barotrauma is discomfort in the ear caused by pressure differences between the inside and the outside of the eardrum.
The air pressure in the middle ear is usually the same as the air pressure outside of the body. If the eustachian tube (the connection between the middle ear and the back of the nose and upper throat) is blocked, the air pressure in the middle ear will be different than the pressure on the outside of the eardrum, causing barotrauma.
Barotrauma commonly occurs during altitude changes (i.e., while flying, scuba diving, or driving in the mountains). If you have a congested nose from allergies, colds, or upper respiratory infection, barotrauma is more likely.
How can I prevent ear and sinus problems
due to altitude change (barotrauma)?
If you are currently experiencing:
stuffy nose, ears, or sinuses,
significant allergy symptoms,
or if you have had problems with ear or sinus pressure during altitude changes, consider the following measures to help prevent painful ear or sinus problems from air pressure changes, which can occur if you have the above symptoms and are flying, going over mountain passes, or scuba diving (do not dive if you can't readily clear your ears or sinuses), or you travel via underseas railroad tunnels ("Chunnel", in Japan).
Drink 8 oz. of non-alcoholic liquids every hour, so that your respiratory secretions will not be thick. Aircraft in flight have less than 5% humidity. Bear in mind that alcohol also dries you out. Airplane tap water should not be assumed to be safe, but on-board ice can be considered safe if the flight came from a developed country. Plan to carry your own water bottle.
Pseudoephedrine (Sudafed) is an oral decongestant that can effectively shrink swollen tissues. For a short-term effect, take 60 mg 2 hours before each (airplane) descent (no closer than 3 hours between doses). For a longer term effect, take 12 hour Sudafed tablets every 12 hours, beginning at least 48 hours before each day flying (more severe problems may require one every 8 hours). To minimize interference with sleep, time it so that one dose is minutes before your bedtime.
Some persons will also need to use Afrin (oxymetazoline) nasal spray beginning 48 hours before each day flying. Follow the directions on the label.
Try to swallow frequently or chew gum on descent. These maneuvers may also help: With the mouth closed and nostrils pinched shut, swallow or gently try to blow air out of the nose.
Benzedrex (propylhexedrine) Inhaler (check expiration date) should be inhaled nasally at the first sign of increased pressure in ears or sinuses. It may be repeated as often as needed while having symptoms during flight or altitude change.
These over-the-counter medications are approved by the FAA and military flight surgeons for use by air crew members.
For more information
Ear Barotrauma (MedlinePlus)
Barotrauma (American Hearing Research Association)