Flying and the ear
Last updated on 14 November 2012
Some people with hearing loss or tinnitus worry about travelling on a plane. This information has been produced to address common questions and concerns.
The effect on the ear of take-off and landing
Taking off does not usually cause a problem as the pressure in the aircraft cabin decreases. The air in the middle ear is at a relatively high pressure and passes down the Eustachian tube (connecting to the back of the nose), rather like releasing the neck of a balloon. If there is going to be a problem with equalising pressure in the middle ear it tends to occur when the aircraft comes down to land. At this time the air in the middle ear is at a lower pressure than the air in the cabin.
If your Eustachian tube is blocked, your ears will not “pop” and pressure cannot equalise. Eustachian tube blockage can occur for a number of reasons. The most common are colds, sinus infections and nasal allergies, which stop the air flowing through the blocked Eustachian tube. This causes lower pressure inside the middle ear; the eardrum is then sucked inward and stretched. Such an eardrum cannot vibrate naturally so sounds seem muffled or blocked. In extreme cases, usually during rapid descent, the ears can become painful.
Some people are worried that the noise of the engines will damage their ears or cause their tinnitus to get louder. This is very unlikely. Many people actually find flying to be one of the times when they are completely free of their tinnitus because of the background noise of the engines.
If you find the noise of the engines disturbing, the solution is either to select a seat in front of the wing, or as a last resort, to use soft earplugs. If the sound level is not a problem, do not use earplugs, as blocking outside sounds may make your tinnitus appear to be louder temporarily. If you have been fitted with wearable noise generators, it can be helpful to use them during a flight.
If you normally wear hearing aids, you should also wear these during your flight, as removing them may make your tinnitus louder and more noticeable. For people with hearing loss, it is often "straining to hear" that makes the tinnitus seem louder when on board the aircraft.
If Eustachian blockage is experienced during flying, then tinnitus may appear to get louder temporarily. On clearing the ears, for example by swallowing or yawning to open the Eustachian tube, the tinnitus will return to its former level.
Pressure changes and tinnitus
In some cases, changes of pressure do have small and temporary effects on tinnitus. It may change the frequency, and in some cases may temporarily increase or decrease the loudness. Most tinnitus sufferers do not experience these effects, and it must be stressed that, if they do occur, they are only temporary.
Grommets and perforations
Grommets are very small ventilation tubes used in the treatment of certain ear disorders. Perforations (or holes) can occur in the eardrum as a result of infection or injury. In either case there is actually less of a problem flying than if the eardrum is intact. This is because any change in pressure can be equalised across the eardrum through the hole or tube, and does not depend on the Eustachian tube functioning normally.
Flying and middle ear surgery
If you have recently undergone other middle ear surgery, or are about to do so, it is important to check whether or not you will be allowed to fly immediately afterwards. If you have had an eardrum perforation repaired (myringoplasty), or the stapedectomy operation for otosclerosis, you are usually required to avoid air travel for a short period whilst the ear is healing. Ask your ear specialist for their views.
Many people with hearing disorders and particularly those who have tinnitus can find it aggravated by varying degrees of depression and anxiety. Many people become anxious because they are worried about flying. This can make tinnitus seem worse.
Do discuss your anxieties with your GP. He or she may suggest a small dose of a tranquilliser. Relaxation and breathing exercises can be extremely helpful, particularly if practised beforehand. If the fear of flying is well established, some commercial airlines (for example British Airways or Virgin Atlantic) run a “desensitisation” course and they can be contacted directly about this.
Top tips for a comfortable flight
Be reassured that most people with tinnitus do not experience any adverse effect on their condition whilst flying. In the unlikely situation that they do, it is likely to be only minor and temporary.
Here are a few tips on how to make the trip more comfortable:
- Avoid using earplugs during a flight. When you seal out background noise, your tinnitus may become more pronounced.
- Sit in the front of the plane where the engine noise isn’t as loud. Anywhere in front of the wings will be an advantage.
- Swallow and yawn as much as possible. This will open the Eustachian tube and allow air to enter the middle ear. When outside air pressure changes, the Eustachian tube supplies a bubble of air and the ears pop. When this happens, air pressure has been equalised.
- Chew gum or suck on a sweet. It will cause you to swallow more often and help equalise the air pressure during take-off and descent.
- Stay awake during descent. Descent is the part of the plane ride where you have a harder time adjusting to the pressure changes. Your Eustachian tube and ears don’t adjust as well when you are sleeping so it’s important to stay awake.
- Try to avoid flying if you have a cold or upper respiratory infection as it can make it more difficult for your Eustachian tube to operate.
- A nasal decongestant may be helpful. Even if you are not suffering from a cold, this may help keep those airways and tubes open for better pressure release.
- Leave your hearing aids in place as you may find them particularly helpful during a flight.
- Make full use of the entertainment offered on the flight. Listen to music or watch the inflight film as they help to take your focus away from your tinnitus. If you tend to get nervous when travelling by air, the entertainment may also help you relax. Avoiding stress and worry helps to minimise the effects of tinnitus.
Full references for this article can be obtained from the address below.
British Tinnitus Association
Ground Floor, Unit 5, Acorn Business Park,
For further information
Our helpline staff are available to answer your questions on this and other tinnitus related topics on 0800 018 0527.
Liam Masterson MRCS DOHNS RAF
© British Tinnitus Association
Written March 2012 .Version 1.3 revised November 2012. To be reviewed November 2014
This information has been produced in compliance with the BTA’s Information Production Protocol and no conflicts of interests have been declared. For more information on this and the Information Standard, please see here.
Many people actually find flying to be one of the times when they are completely free of their tinnitus
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