Flight Training Aeromedical Issues - Managing Changes in Ear Pressure

Understanding how an aircraft operates is critical to establishing a solid foundation in aviation. Student pilots are also taught how vital the human aspect of flight is - the pilot. A well rested, drug- and alcohol-free pilot is a great start - but what about a checklist to make sure our inner instruments are fully functioning, ensuring our bodies are ready for flight?

The typical human body can withstand tremendous pressure changes. From our digestive system to our ears and sinuses - making sure all systems are "cleared for flight" is important to eliminate distraction when flying.

Gas inside any cavity in our body expands with altitude. This is not really a problem as long as this air can be released if needed. An air bubble in the gut can make us squirm with discomfort or pain when unable to be released. The solution may be stinky depending on what was on the menu, but the release of this air is a relatively simple process.

A build up of pressure inside the ear can occur if the Eustachian tube (the "regulator" tube connecting the inner ear and the nose) does not open to regulate air within the middle ear. Plugged ears cannot only cause pain, they can initiate negative pressure and suction which may result in hearing changes, fluid build up, a feeling of fullness in the ear, and for some - excruciating pain.

Learning how to do the Valsalva maneuver is something every pilot must know how to do to help regulate inner ear pressure with altitude changes. This maneuver as well as yawning or opening and closing the mouth can be all that is needed to help the little Eustachian tube open and regulate the pressure of the middle ear cavity.

As a pilot, you not only have to worry about your ears, you've got to keep your passengers' health in mind too. When starting a descent, even in a pressurized aircraft, it's always a good idea to remind passengers to "keep your ears popped" and to let you, the pilot, know if anyone is having an inner-ear issue and experiencing discomfort. If someone on board is having trouble, the best thing to do is let ATC know you've got a medical situation and need to climb back up to a comfortable altitude to relieve the ear pain, and then begin a slow descent while working to open the Eustachian tube of the affected ear.

What happens when the Valsalva and yawning or chewing gum doesn't work to "pop" that ear? When pilots and passengers fly with congestion from allergies or a cold, the little Eustachian tube may have difficulty opening. When the Eustachian tube doesn't work properly, ear pressure, pain, and fluid can quickly develop. If not relieved, this fluid and suction-like negative pressure prevents the tympanic membrane (ear drum) from vibrating and properly transmitting sounds to the nerves and brain. The result is hearing loss.

Ear pain and hearing loss are never good things. For student pilots concentrating on successful flights, trying to land a plane in severe pain, or missing a call from ATC could have devastating results.

Micromedics, Inc., a well-known manufacturer of ear tubes, produces the EarPopper, a Eustachian-opening "packable" device that eliminates the plugged ear issues. This small battery-operated device allows anyone suffering with negative middle ear pressure to pack a smart solution when flying, scuba diving, or dealing with colds or allergies.

Another option for pilots is to carry a bottle of spray nasal decongestant. The most common and effective decongestant is oxymetazoline, which is the active ingredient in Afrin and similar nasal sprays. If all other attempts to clear a blocked Eustachian tube have failed, a dose of Afrin or similar decongestant may be enough to open the tube. However, these sprays take a few minutes to work, so plan on climbing back up to a "comfortable" altitude for you or your passenger, and be sure to let ATC know you have a medical situation on board.

As a registered nurse and travel expert, my career is to find "products worth packing" for travelers. I discovered the EarPopper at a Pediatrician conference a few years ago. I have seen the EarPopper used by pilots, flight attendants, and passengers as young as three years old to effectively open the Eustachian tube.

Now as a consultant for Micromedics, my passion is to spread the word about the EarPopper device to those who rely on the little Eustachian Tube to perform well at changing altitudes. The EarPopper is a valuable tool for pilots (from students to veterans) who may fly with congestion, allergies, or plugged ears. As a resource for those considering the EarPopper, check out the EarPopper blog

Avoid being grounded by ear issues, travel with the only clinically proven, FDA-cleared device for dealing with negative pressure in the middle ear.

"Clear Left, Clear Right" takes on new meaning when packing the EarPopper.

Anya Clowers (@EarPopperNurse) is a registered nurse, consultant, travel expert, author, and speaker. Her passion for quality travel has led to her research of "Products Worth Packing" for travelers of all ages. She is the author of Jet With Kids, the book, site www.JetWithKids.com, blog (JetWithKids blog), and travel seminars created to educate travelers about self-sufficient travel. Anya is also the daughter-in-law of a CFI, and the mother of a "future pilot" and international "frequent-flier-in-training," who has enjoyed traveling to 17 countries before finishing kindergarten.