What causes severe ear pain during air travel?

Generally, the main causes of severe ear pain during air travel may include pressure changes, tympanic membrane retraction, eustachian tube dysfunction, secretory otitis media, and acute otitis media. A detailed analysis is as follows:

1. Pressure changes: Variations in air pressure can lead to differences between the pressure within the middle ear cavity and the external pressure, exerting force on the eardrum and causing ear pain. Swallowing or chewing gum can help improve eustachian tube function, thereby alleviating the discomfort.

2. Tympanic membrane retraction: Tympanic membrane retraction is usually caused by negative pressure in the middle ear. When the pressure within the middle ear is lower than the external pressure, the eardrum may retract inward, causing pain. This may also be accompanied by tinnitus, hearing loss, and a feeling of ear fullness. Wearing specially designed earplugs can reduce pressure fluctuations within the ear cavity, thus relieving ear pain.

3. Eustachian tube dysfunction: This may be related to upper respiratory tract infections, rhinitis, sinusitis, and other factors. The eustachian tube is the passage connecting the middle ear cavity to the nasopharynx. When its function is impaired, the pressure within the middle ear cannot equilibrate with the outside pressure in a timely manner, resulting in ear pain. It may also be accompanied by symptoms of upper respiratory infection such as nasal congestion, runny nose, and cough. Medications such as triamcinolone acetonide nasal spray, mometasone furoate nasal spray, and azelastine fluticasone nasal spray may be used under medical guidance to alleviate symptoms.

4. Secretory otitis media: This may be caused by barotrauma, eustachian tube blockage, upper respiratory tract infection, and other factors. When the pressure in the middle ear cannot be balanced in a timely manner, it may cause congestion and edema of the middle ear mucosa, leading to pain. It may also be accompanied by systemic symptoms such as tinnitus, hearing loss, ear fullness, and fever. Medications such as amoxicillin capsules, roxithromycin tablets, and cefalexin dry suspension may be used under medical guidance for treatment.

5. Acute otitis media: Usually caused by upper respiratory tract infections. When the middle ear becomes infected, an inflammatory response occurs, which may lead to pain. It may also be accompanied by systemic symptoms such as tinnitus, hearing loss, fever, and headache. Medications such as penicillin V potassium tablets, amoxicillin tablets, and cefixime granules may be used under a doctor's instructions for treatment.

During air travel, it is important to remain relaxed, as tension can cause muscle tightness and affect the patency of the eustachian tube. If ear pain persists or worsens, prompt medical attention should be sought for professional diagnosis and treatment.