Okay, I need some help with this one, folks. I work in a remote area that requires all the workers to fly back and forth to the real world. The climate at the work site is such that people occasionally have head colds and sinus congestion. I was recently told about a worker who was due to fly home, but was told by the medic (not a doctor) that there was a chance of having an ear drum rupture because of the “low pressure” on the aircraft. The worker decided to stay at the work site rather than taking a chance of having a ruptured ear drum. My question: (assuming the advice was valid) wasn’t there something the medical department could have done to enable this worker to get on the aircraft and go home?
I know that some cabin attendants have had those “ear tubes” put in because they’ve had similar problems, but that would seem a little drastic for just occasional flying.
Usually you can unblock your ears with the Valsalva maneuver.
If you have a cold, you may try a decongestant before flying (as long as you’re not at the controls).
If the blockage is severe enough that a medic tell you to stay on the ground, then stay on the ground.
One problem with taking a decongestant is that it may clear it enough for your ears to equalize at altitude, but then they’ll block up again and they won’t be able to equalize when the plane comes down. Then you’ll have a painful ‘reverse squeeze’ with no way to get easy relief.
If you’re flying out of a remote site in a smaller aircraft, it may not be pressurized which could make the problem worse if you’re flying at higher altitudes.
Personal experience:
I spent the most miserable 2 hours of my life (yup, worse than labor) in a small prop job flight from Ft. Sam Houston to Ft. Polk, LA with a bad head cold & an earache.
Swallowing, which normally releases middle ear pressure in a low-pressure environment did nothing, because my Eustachian tube (connects middle ear to pharynx) was swollen shut.
Back to answering the OP:
Decongestants, such as pseudoephedrine (Sudafed) or phenylpropylalanine (PPA) may be helpful, but usually nasal sprays are even more effective. Usually, large commercial airliners are sufficiently pressurized that this is not a major problem; however this situation sounds more likely to be one with an unpressurized small aircraft.
Depending on the severity of the inflammation in the nasal pasageways, such over-the-counter meds might have worked, but it may have been more prudent to make sure the swelling improved before flying your co-worker home.
One other point; many people mistakenly believe that ruptured eardrums cause deafness. They can cause (at least temporarily) hearing loss, but not complete deafness on the affected side. Think about how many kids get earaches now. Back in the days before antibiotics, nasal sprays & Sudafed, kids did not die from these infections; the eardrum ruptured, allowing the infection to drain into the ear canal, Eventually, the eardrum scarred over & hearing returned to close to normal in most cases.
Sue from El Paso
Siamese Attack Puppet - Texas
Experience is what you get when you didn’t get what you wanted.
Thankfully, I’ve never had this problem. For some reason I can equalize pressure at will (kind of the yawning method, but really it’s just moving my jaw muscles slightly… hard to explain). Am I a lucky freak?
Thanks for all the info. We fly in a 737, so my guess was that it would have been okay for this worker to fly. I was told a long time ago that the Valsalva Manuever was not a good idea - don’t remember if was in connection with flying in un-pressurized aircraft or in connection with diving. I also learned a long time ago how to clear my ears/sinuses (or is that sinui) by opening my mouth and swallowing at the same time. Kinda tricky, but once you learn it, you’ll no problems on flights. You folks are a goldmine of information and I have another question or two I’ll ask in other threads. Thanks again for all your help.
I’d forgotten about the nasal sprays. Usually my sinusus don’t get so bad that I need to use one.
The Valsalva maneuver the preferred method for equalizing pressure when I went through the “altitude training” at Edwards AFB. No mention was made of it being harmful, and I’ve always used it when flying or diving.
The Valsalva manuever only works when middle ear pressure is LOWER than ambient pressure.
There are actually a number of “Valsalva maneuvers”, but as applied to relieving middle ear low pressure, the one I am familiar with works as follows:
- Take a deep breath in.
- Keep your mouth closed, and hold your nose.
- Try to exhale.
- Hold your breath & wait until you get a popping sound in each ear. Open your mouth & breathe out.
This increases pressure in the pharynx, enough to force open the Eustachian tube & allow pressure inside the middle ear to equilibrate with outside pressure.
The danger to it is that if the Eustachian tube is not working well enough to allow middle ear contents to drain, then blowing all of bacteria normally in our throat into the middle is likely to cause an infection.
Val•sal•va maneuver \val-"sal-ve-\ noun [Antonio Maria Valsalva †1723 Ital. anatomist] (1886)
: the process of making a forceful attempt at expiration while holding the nostrils closed and keeping the mouth shut for the purpose of testing the patency of the eustachian tubes or of adjusting middle ear pressure — called also Valsalva
©1996 Zane Publishing, Inc. and Merriam-Webster, Incorporated. All rights reserved.
“I have gathered a posie of other men’s flowers, and nothing but the
thread that binds them is mine own.”
Majormd: okay, so the Valsalva Manuever is ill-advised if you are in an aircraft at altitude with no pressurization (like a door is open), is that correct?
Majormd, Johnny L.A., et al: I looked around the Encyclopedia Britannica and found what I was referring to earlier in this thread - “sinus squeeze”.
“Sinus squeeze is a common malady of persons flying in unpressurized aircraft and of divers.” wow, I didn’t realize I could copy and paste from another website to this bulletin board. Anyway, that’s a quote from the website I mentioned earlier. I hope I didn’t violate any rules of posting here by mentioning another website.
The issue with the Valsalva maneuver is that while it helps increase pressure inside the middle ear as you are landing, it doesn’t help as much at altitude (low pressure), where you’re most likely going to be suffering from too much pressure inside the ear. This is not an absolute, but when the problem is to much pressure inside the ear, such activities as swallowing (with or without your mouth open), or chewing gum are more likely to open the Eustachian tube & allow the higher pressure middle ear gasses to flow into the pharynx.
In medicine, btw, the Valsalva maneuver is most often used to elicit a heart murmur, or to try to stop an abnormal heart rhythm. There, the standard instruction is to hold your breath without holding the nose, & bear down like you’re trying to have a bowel movement. When this is done, the vocal cords close, and there is no increased pressure inside the pharynx, so this does not help equilibrate pressures in the sinuses & middle ears.
- Sue
From what I’ve experienced, I would definitely take the doc’s advice about not flying. Once I came down with a flu-like illness while on a business trip. On the flight home, my sinuses were draining comfortably while the plane was climbing. I thought that flying must be a good thing to do while stopped up - I should do it more often.
Then came the descent. As the plane was coming down, I had the most painful sensation I think I’ve ever had. It felt like my eyeballs were being sucked into my head and were about to burst. I had tears streaming down my face, somewhat embarrassing for a thirty-year-old man, and I kept checking the wetness on my face because I expected to bleed out at any moment. I seriously considered requesting that the crew take the plane back up, but besides for being not likely, I figured it would just prolong my misery.
But I really thought that I might have been experiencing serious injury. After the plane landed, I was fine. I wouldn’t recommend this for anyone.
Just a side note.
IIRC, most airliners (meaning those that cruise above 25000 feet) carry a “cabin altitude” of roughly between 6000 and 10000 feet above sea level, depending on cruise altitude and other factors. This is one reason we feel so loopy after a flight, and people with ear problems should definitely consider.