by Neil Bauman, Ph.D.
A lady explained,
I suffer from hearing loss and a feeling of blocked ears. When going on a plane last week, when the plane took off I went completely deaf and my hearing stayed that way the whole journey. After landing, it has taken over a day to get my hearing back. Why has this happened?
Before I explain what happened and why, let me give a short explanation of how your middle ears work. Each of your middle ears are connected to the back of your throat by an Eustachian tube. Normally, a small muscle keeps your Eustachian tubes closed. (If they remained open you’d hear loud breathy sounds each time you breathe, and your voice would sound much too loud.)
When your Eustachian tubes are working properly, each time you swallow or yawn, they open momentarily. This allows any difference in air pressure between your middle ears and the air around you to equalize. This is important because if the air pressure is greater in your middle ear than in the air around you, it creates a balloon effect in your middle ears. This pushes your eardrums away from the first of the tiny bones—the malleus (hammer). When this happens your eardrum has to move further before it can push on the malleus—thus you don’t hear as well. (For example, soft sounds don’t move your eardrum enough for it to move the malleus so you don’t hear them.)
Fortunately for us, whenever we yawn or swallow, the muscle closing each Eustachian tube relaxes and the Eustachian tube opens momentarily. This either allows air to rush in (if the middle ear pressure was too low) or rush out (if the middle ear pressure was too high). You only notice this when your ears “pop” when the pressure change is significant. The rest of the time you are totally unaware this is happening.
However, if anything blocks your Eustachian tubes, then this air exchange can’t take place and your eardrum may be left sucked in or bulged out. Either way, it affects your hearing. Typically this occurs when you have a cold or are congested, perhaps from allergies. Mucous in your throat gets sucked up and stuck in your Eustachian tubes and blocks them so no air exchange takes place. If there are no pressure changes taking place, you don’t notice this much.
However, when you are taking off or landing in a plane, air pressure changes are occurring rapidly as you ascend and descend.
When your Eustachian tubes can’t open so no air gets exchanged, the pressure differential bulges your ear drum out so it is pushed away from the tiny hammer bone and you notice you can’t hear well anymore.
Unless you have a severe hearing loss to begin with, you don’t actually go completely deaf—it just may seem like it.
I know that if I don’t swallow or yawn I can let my ear drums bulge out so that I can’t even hear the roar of the jets. It’s very peaceful flying that way if you don’t mind the feeling of pressure in your ears. But as soon as I swallow, things return to normal and I hear the jets again.
If your ears are still blocked when you land, you’ll still have problems hearing as you have found out. Fortunately, over time, the “gunk” blocking your Eustachian tubes drains out and air exchange begins again. When this happens, your hearing
returns to normal.
If your ears are blocked, you may choose not to fly. If you do have to fly, some people find that using decongestants just before and during flights helps them avoid this problem.
I suffer from hearing loss altogether from my right ear.. would that affect my ears if I fly.?
Hi Elena:
If you have an inner ear (sensorineural) hearing loss, then flying shouldn’t bother it. I’ve flown numerous times without any problems. If your ears/sinuses are congested, then flying can bother you if pressure builds up in your middle ears. Some people who are congested take a decongestant before taking off and before landing to help alleviate this problem.
If you have enlarged vestibular aqueduct syndrome and are sensitive to pressure changes, then you can have problems, but if you’ve previously flown without problems, then LVAS shouldn’t cause you any problems now.
Cordially,
Neil
I flew home from Florida 8 days ago with a bad cold – upon landing both ears blocked and I still have not gotten my hearing back. I went to the dr for a Z-pack and some steriods and they are still clogged up. The flight made it worse and the dr said there is fluid in my ears. At least the pain is gone but I can not hear well. What more can be done at this point to clear my ears? Never had hearing issues before.
I have the same problem!! Any resolution??
My son is 18 months old and will be flying for the first time next week. Will this be an issue for his tiny ears?
Hi Victoria:
It shouldn’t be if his ears/sinuses are not clogged. But you can make things easier on him if while you are ascending and descending he is actively swallowing which equalizes ear pressure inside and outside the middle ears. So if he is eating, drinking or sucking on a pacifier at those times that should do the trick. You don’t have to worry once you are “upstairs”, just when going up and down.
Cordially,
Neil
My husband had the opposite problem. He is really deaf in one ear, however on flights his hearing comes back perfectly until a couple of hours after we land – then he’s deaf again. What might cause this and does it sound like something that could be fixed without just his hearing aids?
Hi Clare:
That is indeed unusual. I’ve not run across that problem before. However, I suspect what is happening is a pressure problem. I have a few questions so I can better understand what he is experiencing.
First, exactly when does his hearing begin to return–while the plane is still on the ground, climbing up to cruising altitude, when you reach cruising altitude, or an hour or more after reaching cruising altitude?
How much hearing loss does he normally have in his bad ear? Is this hearing loss conductive or sensorineural?
Does his ear feel “blocked” or “full” most of the time? Does yawning or swallowing alleviate this feeling?
Does his hearing come back suddenly (instantly), or gradually over several minutes or and hour or so?
How long has this being going on for–recently, months, or what?
Does he have sinus problems or allergies?
Hopefully, the answers to the questions will tell me what is going on.
Cordially,
Neil
Does yawning or swallowing
Hi
Thanks for your reply.
His hearing comes back completely when he reaches cruising altitude. His ears pop and his hearing is back. The same happens every now and then when he blows his nose, but it only lasts a few minutes. It’s been going on for years. He has no sinus or allergy problems. He’s been given sniffer medicines occasionally to make sure his sinuses were clear.
Seems so strange it comes back so clearly in the air He had grommets inserted when he was a child for fluid behind the eardrum.
Thanks
Hi Clare:
As I see it, he has Eustachian tube dysfunction such that he has a deficit of air in his middle ears so the vacuum pulls on the eardrum/bones in such a way that they don’t transmit sound well–thus he has a hearing loss. However, when he flies, the air pressure outside is reduced, thus sucking his eardrum more into the correct position as the air in his middle ear expands and he hear again, until after he lands and the oxygen is used up, creating a vacuum again and his hearing goes. That is one theory.
I’m interested in whether he hears well on the tops of mountains as there is reduced air pressure there. Planes are pressurized to about 6,000 to 8,000 feet above sea level, so if he was on a mountain 6,000 plus feet above sea level, I’d think he would hear as well as if he were flying. I don’t think it is the flying that causes the change in hearing, but the difference in air pressure.
Cordially,
Neil
Hi
Not sure about up mountains as we’ve never tried that one. Maybe in the summer we’ll have to try it out. If it did come back up a mountain too, do you think it might be something fixable other than a hearing aid?
Many thanks
Hi Clare:
If it is a simple pressure problem, then it should be medically fixable.
Cordially,
Neil
I am very interested in the comments about the convexity/concavity of the eardrum affecting contact with the hammer.
I am a private pilot and was in a relatively rapid descent when my left ear popped, nor particularly different from a commercial flight, and a feeling of fullness developed, as though I needed to pop my ear. I lost my hearing entirely in that ear and have elevated tinnitus now.
Doctors have said the eardrum looks fine – can they tell if the convexity issue you mention is at play through a simple inspection?
It might also be relevant that the descent was over the mountains in a good sized storm, so I think I exacerbated the barometric effect of the descent by flying through a front with its own pressure changes. This was 17 months ago.
Thanks very much in advance -m
Hi Matt:
What does your audiogram show for hearing in your left ear now?
I’m not surprised you have tinnitus in that ear as tinnitus often accompanies hearing loss, so the hearing loss made your tinnitus worse.
Doctors can see if your eardrum is bulged out or sucked in. So if your doctor said it looks fine, it is probably working as it should work.
You shouldn’t have had any problems with the rapid change in pressure as your descended if you yawned or swallowed periodically to relieve the pressure build-up as you descended.
However, if your Eustachian tube was clogged up so your ears didn’t pop, that would cause a problem.
Does your ear still feel like it needs to pop, or is it normal now?
Cordially,
Neil
Neil, thank you for your reply, and I’m only just seeing it now after going down the google rabbit hole again on my hearing issue.
The audiogram, which I’d be happy to send you, shows moderate loss at the lowest freq, which gradually worsens as frequencies go up to a “profound” level at the highest. I also have 0% word discrimination in my left ear.
I do feel the need to pop my ear, but with no relief. When I landed (nearly 2yrs ago now), I thought I just needed my ear to clear/reset, so I was slow to seek treatment (about 10 days). It never really did release.
The docs have all said my eardrum looks fine, so I guess they have evaluated the potential convexity of it vs the position of the hammer.
In any case, I am grateful for your response and again I apologize for the delay.
Hi Matt:
Send me your audiogram and I’ll take a look at it and see what I think. Your eardrum may look good to your doctor, but the proof of things working properly is the results of your tympanometry that should be on or with your audiogram.
Cordially,
Neil
I travelled 10 months in November 2021 and upon landing I lost hearing in my left ear but with no tinnitus then I went back home after 5 days and visited my ENT physician who did PTA and send me to take CT scan for middle ear and advised me to wait for couple of days and I will improve and actually I get my hearing back after 2 weeks but unfortunately I didn’t repeat the PTA as I felt better then after 5 months I planed to flight so I visited my ENT again and he checked me and said everything is ok but it’s better when I get on the plane to use atrovine and chew gum but unfortunately upon landing I lost my hearing again but this time with tinnitus so i waited 5 days then I went to see an ENT who did PTA and said I have sensoneural hear loss and should start systemic corticosteroids immediately so I started with 90 mg for 3 days then 80 for 3 days then tapering down and 3 weeks no improvement so I did MRI to rule out tumor and everything was ok so my ENT suggest grommet tube for local steroids injection with 5drops of 8mg dexamethazone every other day for 2 weeks but with minor
improvement on PTA
Now it’s 90 days from last accident but I have no diagnosis and don’t know if I can fly again
When I get my complete hearing back
Hi Mohannad:
Had you flown before November 2021 without any ear problems, or was this the first time flying?
Were your ears congested before this flight and subsequent flights?
If your ears are congested it is not a good idea to fly, or to take decongestants about an hour before scheduled take off, and again about an hour before you begin the descent. This can help prevent ear problems from this cause. You may also find it very helpful to wear special ear plugs called “earplanes” that slowly allow the pressure on your ears to equalize as you go up or down.
Normally, if your ears are congested, the hearing loss goes away as the “gunk” in your ears drains out through your Eustachian tubes and allows your ears to function normally again.
However there is another condition called Enlarged Vestibular Aqueduct Syndrome (EVAS) that causes sensorineural hearing loss due to pressure changes in your ears. Often, after a few days to two weeks, hearing returns or at least some hearing returns. Wearing earplanes can really help if you have EVAS. With EVAS typically you’ll end up with some degree of permanent sensorineural hearing loss.
You can read my comprehensive article on EVAS and see if this fits your experience, rather than the first possibility (ear congestion due to colds, etc.) The link to this article is https://hearinglosshelp.com/blog/large-vestibular-aqueduct-syndrome/ . If you want to learn even more, I have written a number of articles on various aspects of dealing with EVAS. You can find them by clicking on the Blog button on my website, then from the “Hearing Loss Research & Resources box”, choose Large Vestibular Aqueduct Syndrome from the drop down list of categories.
Cordially,
Neil
I flew over a month ago and my hearing has not yet returned. Unfortunately I had a bad cold and was not aware of the problems that can occur when flying with one. I have been to the doctors and they saw blood in my ear drum and confirmed I had an infection. I had antibiotics twice which I finished a week ago. I still have fullness in my ear and hearing has not improved. Shall I go back to the doctor or wait a while too see if this resolves itself? I have been doing saline nasal washes to try and ensure my sinuses aren’t blocked and also euchstian tube massage.
Hi Liz:
If you are flying and have any congestion, either reschedule your flight, or take an antihistamine about an hour before take-off and anther about an hour before landing.
At this point, a month later, since your hearing has not returned, I’d go to an audiologist and ask for a “complete audiological evaluation”. This will tell you the current status of your hearing and whether you have a sensorineural (inner ear) hearing loss or a conductive loss.
If you have a conductive loss, it is likely that your middle ear/Eustachian tubes are still clogged up. Sometimes it can take a couple of months to clear.
However, if it shows only a sensorineural hearing loss, the clogged feeling can be your brain giving you that clogged feeling due to the hearing loss. You brain says to itself, “My ears much be clogged up or else I’d hear normally, wouldn’t I?” and thus it gives you the clogged-up feeling, even though there is no physical clogging.
Be aware that antibiotics can also cause hearing loss so you could have gotten a “double whammy”.
Cordially,
Neil
My mom is completely deaf in one ear due to SNHL. This was a freak thing that happened when she was 12 and dove off the diving board at her local public pool. The water was 10 ft deep and the diving board no more than 15 feet above the water. She dove in, came up and couldn’t hear out of one ear. She felt like it was full of water…it wasn’t. No pain, but never regained hearing in that ear.
Because of this, and lack of access to doctors specializing in audiology, she’s never flown in an airplane due to fear she will lose hearing in her other ear and go completely deaf. She’s worried the sudden change in pressure on a plane will have the same effect her diving experience had…and no doctor has given any clear answer on if that would be something that would happen or not if she did fly.
I’m moving internationally soon, and am worried my mom will never be able to visit me in my new home. Any info you can share would be greatly appreciated. And any specialists you can recommend in the Kansas City area would be a bonus, thanks!
Hi Drew:
Does your mom have an audiogram that shows she is completely deaf? It is highly unusual that anyone is completely deaf unless they have their auditory nerve cut. I’d love to see a copy of her audiogram.
This diving incident she had at 12–was this the only time she dived from that diving board, or had she done it other times without incident? And also, did she ever dive again after that incident?
Why does she think it was the sudden change in pressure that caused her deafness and not something else?
Has she ever been scanned to see whether she has enlarged vestibular aqueducts? This is one of the first things I’d do in order to answer questions about sensitivity to pressure changes.
Before this diving incident, did she have any minor incidents of hearing loss?
Has she gone up the elevators in tall buildings without any hearing problems? Ditto for driving up high mountains.
I need to know more about her history and answering my questions and getting the results of a brain scan of her vestibular aqueducts would be a good start.
Incidentally, if she wears Ear Planes when she flies, these ear protectors slow the change in air pressure so the effects of the rapid changes in air pressure after take off and before landing are slowed down considerably, and this can prevent some ear problems.
Cordially,
Neil
Drew I went completely deaf in one ear it’s been like that for about 15 years i was told back when I went deaf in my left ear not to ever fly the percentage of going deaf in my other ear is low but I’m to afraid to take the risk and none of the 5 doctors could figure out why I went deaf in my left ear but before I went deaf in that ear I did fly several days before
Hi Michael:
Have you been checked out to see if you have EVAS/LVAS (Enlarged vestibular aqueduct syndrome)? If you have this condition, you may find that sudden pressure changes will affect your hearing. This can happen when diving underwater where the pressure increases, or flying in a plane where the pressure decreases. It can also happen when you have head trauma that momentarily increases internal pressure.
That’s what I’d suggest. An MRI or CT scan can reveal whether you have EVAS or not.
Cordially,
Neil
Hi Doctor! I just went to see an ENT a week ago because I’m suffering from tinnitus and pressure in my left ear so I went to see him and he said I have conductive loss and I might’ve got it from allergies which I did get before seeing him so he prescribed me some steroids for 5 days and it didn’t help much. And now I’m flying and I’m concerned if this is gonna get my ear worse. Pls help!
He even told me to try to pop my ears but my left ear wouldn’t pop. He said it’s being sucked in and need to pop it back out.
Hi Judessa:
If your middle ear is clogged up, you don’t really want to fly as the changes in pressure can really hurt. What you can do do is take a decongestant about an hour before take-off and another one about an hour before landing. This can really help.
Cordially,
Neil
But will flying makes my ear worse? I tried to scheduled another appointment but he will be out of town. I was planning to get my ear feel better first before flying and now I don’t know what to do.
And also, will this clear up on its own? Or an ENT should do something about it? Thank you so much for taking the time to respond to me. Appreciate it so much!
Hi Judessa:
If your middle ears are clogged up, the pressure changes from flying can make things worse, at least temporarily. How soon are you flying?
It’s always better to get your ears back to normal before flying. Have you tried any OTC decongestants to see if that helps unclog them?
Most middle ear problems clear on their own when the allergen levels drop, or cold symptoms go away. It can take up to two months depending on how clogged up they are and how thick the gunk is. But unless it gets infected, you don’t need to take any medications for it. Just let nature take its course.
If decongestants make your ears feel better now–not feel blocked when you yawn or swallow, then you could expect them to do the same for you when flying, and thus you should have no problems.
Cordially,
Neil
I’m flying first week of May and what can you recommend OTC decongestant? I’ve never tried it before and I’m hoping it will make it better and it would be such a relief if I would be able to pop it. I’ve never had this before it’s so weird.
I’m curious if I this will clear up would the tinnitus would go away as well? It’s the most annoying thing.
Hi Judessa:
I’d ask your pharmacist about the best decongestant for you.
IF your tinnitus is a result of your conductive hearing loss, then there is a good chance that your tinnitus will go away when your hearing returns.
Cordially,
Neil
Thank you so much Doc!