Barotrauma Can Be A Pain, Especially In The Air

Sit next to a baby during an airline flight and you may well receive an earful of glass-shattering shrieks, particularly during the aircraft's takeoff and landing.

For the most part, an infant will scream because of a sharp pain in his ears and sinuses known as barotrauma. The condition is created when there is a difference in the air pressure between the middle ear and the environment - particularly when a plane lands or descends, and the quick pressure change can cause the tympanic membrane in the ear to bulge.

Usually barotrauma causes only an uncomfortable feeling in the ears and sinuses, rather than pain - unless you travel with a cold, sore throat or allergies.

In those cases, a change in air pressure could result in dizziness, ear infections, temporary hearing loss or, rarely, a ruptured ear drum, according to Dr. Russell McMullen, co-director of travel medicine service at the University of Washington Medical Center.

A cold, for example, swells the back of the throat and plugs the eustachian tubes, which connect the middle ear to the back of the nose. The tubes allow equalization of pressure in the middle ear to a person's immediate surroundings. If swollen, the tubes allow little or no air transfer into the middle ear and air pressure cannot be equalized.

"If you cannot equalize the pressure with your middle ear to the outside, (that) can contribute to pain," McMullen said.

Young children are vulnerable to barotrauma because their smaller eustachian tubes plug up more easily.

But you can avoid or help reduce barotrauma by taking preventive steps before your trip. The chief strategy is to use medications that will allow for more air flow into the middle ear by reducing the swelling of the eustachian tubes.

Two experts on this subject offered several alternative remedies.

McMullen suggests adults with colds take a decongestant (such as Sudafed), beginning several days before to the trip. For those with allergies, he suggests a four-hour decongestant/antihistamine (such as Actifed), beginning the day of your trip.

According to McMullen, children also may take decongestants, but they must be made specifically for kids.

A different strategy, recommended by Dr. Douglas Backous, otologist at Virginia Mason Medical Center, is to use a nasal decongestant (such as Afrin).

Caveat: Consult your doctor before using any kind of medicine; Backous notes that these kinds of medications can increase your blood pressure.

McMullen also suggests that you drink lots of liquids to stay hydrated and clear the nose and throat. That's especially important since a side effect of decongestants is dry eyes, and humidity on planes is low.

As the plane descends, chew gum; this will stretch your eustachian tubes open. (Anyone traveling without a cold or allergy can use this exercise alone, without resorting to medication, according to McMullen.)