Eustachian Tube For Dummies (a.k.a. Me)
Human Factor Lesson One – Chapter One – Paragraph One – Line One: the Eustachian tube links the nose and the middle-ear and its purpose is to balance pressure on both sides of tympanic membrane.
Flying when your nose or throat is not clear could result in Eustachian tube lockage, inability to balance pressure, and ultimately to tympanum damage. Not good. I know it, all pilots know it from basic training.
This post is not an ex-cathedra lesson, but a feed-back from a dummy pilot who did not respect this tip, namely… me. On this day I had a begining cold, but nothing serious, so I did not cancel my flight.
Weather was low stratus with unlimited visibility and blue sky on top, in cold high-pressure condition. The plan was an IFR departure, leaving on top, and then a flight to the south of the Alps. The flaw in the plan was an obstructed pass, leading me to divert back to my departure airport… The rest of the flight has been mistakes and consequences…By the time I flew back, the stratus dissipated, but for practice I decided to re-join IFR and fly an ILS approach. Because of trafic I expected an high-speed ILS (160kts to 4 miles final). This speed on a 3° glide-slope corresponds to a rate of descent of approximately 800 feet per minute.
My ears cracked more than usually in descent, and I could hardly compensate the pressure, even by swallowing a lot. Soon, my left ear got completely blocked, and it became slightly painful.
My meteo teacher told me that the atmospheric pressure increase in descent, and the lower the altitude the stronger the increase. As I could not compensate the pressure difference, pain in my ear was slowly increasing, reaching the limit of what I could withstand. The stratus was gone, so I could have cancelled IFR and fly off the ILS for a slow VFR descent. I did not.
As expected the pain increased as the descent continued, making my flying a bit less “precise”. My passenger / co-pilot was fully qualified on the plane and I could easily pass him the controls. I did not.
After landing my left ear was painful, but not bleeding. For the next eight hours I could not hear anything with this ear. It was really disturbing and unplesant, so when a loudly crack unlocked it, the releif was immediate.
This situation evolved in a fully developed otitis, cured in two weeks. A tympanum inspection shown a small crack, hopefully not needing surgery.
One and a half year later I still hear cracks when I sneeze, or when flying as airline passenger. My VFR descents are now slow and carefully controlled as I try not to exceed 500 feet per minute. I had no opportunity to re-fly high speed approaches, but next time I will be very careful of any signs of compensation problems.
I don’t fly anymore with any sign of a cold. Got it ?
8 Comments, Comment or Ping
pat
I had a cold during my two latest flights.
The trick is that I don’t climb higher than 2000ft and limit high speed descents.
I won’t fly a long flight in these conditions, but sometimes my wings tickle too much that I have to go flying….
Dec 30th, 2007
Axel
Yeah, flying in such conditions can be tricky. For some reason the eustachian tube lets excessive air pressure out of the middle ear fairly easily, but getting that air back through the eustachian tube and into the middle ear again when the ambient air pressure is increasing (during decent) tends to be what usually causes the problems.
The eustachian tube is like a one-way valve that will let air pass out of the ear smoothly and easily. This means you can climb out in an airplane and feel perfectly fine. On the other hand, to equalize the pressure in your ears when the ambient air pressure increases, the air has to be forced through the eustachian tube and back into the middle ear again. This effect can be felt even in a perfectly healthy condition and is something most of us have experienced during decent on an airline flight, and is why we keep yawning and swallowing so much in those situations.
Even with the Eustachian tube working this way, it is usually no worse than what can normally be resolved, as already mentioned, either by swallowing or by utilizing the slightly more drastic alternative of the valsalva maneuver – hold your nose and blow. That is normally all it takes and the problems will be miraculously gone!
However, more serious problems can arise if we are suffering from some kind of health contidion which need not be anything worse than a common cold or a hay fever. Such a condition often causes the canals between the nose, ears and throat to clog up. This means the air will have even a harder time than usual passing through the eustachian tube and can very well lead to it being completely impossible to equalize the pressure in your ears during decent. If the difference between ambient air pressure and the air pressure inside the middle ear gets too high and/or remains unequalized for too long, this can result in the chamber of the middle ear being filled up with liquids sucked out of the surrounding tissue in lieu of the air that cannot get through the eustachian tube. This can cause infections and long term health problems with the ears which is naturally something we all would want to avoid.
Fortunately, there are relatively simple precautions we all can take to avoid these types of problems:
1: First of all….if you can, avoid flying if you have the slightest sign of congestion in your ears, throat or nose.
2: Limit your decent rate in the air to less than 500 ft/min.
3: Always bring a nasal spray easily accessible in your flight bag.
If you ever experience any problems during decent that you cannot resolve by blowing your nose or swallowing, level off immediately. Without any further decending, use the nasal spray in both nostrils and wait a couple of minutes to see if it helps on your symptoms. If the symptoms persist and the pressure in your ears remain unequalized, start climbing until the symptoms are relieved. If necessary, give the nasal spray a little extra time to work properly. If the ears still do not clear up, use the nasal spray again and wait another few minutes for it to work. When you feel up to it, start decending again at a slow decent rate. Preferably at no more than 200 ft/min. While decending, monitor the pressure in your ears closely. By any sign that the symptoms are returning and you cannot relieve them by normal means (swallowing, blowing your nose etc), level off to give your ears some extra time to adjust before you continue decending. Use the nasal spray as needed during this process.
Final tip: ALWAYS carry a nasal spray with you when you go flying. It can do wonders!
Good luck and Happy landings!
Jan 4th, 2008
John
Aloha,
I am one of the unfortunate ones who had a slight head cold and traveled back from Bali to Chicago. I developed severe otitis and although I began taking a course of antibiotics, I still lost all my hearing in one ear permanently. So no joke, this can happen.Of course now when I get a head cold (like I have now) it really freaks me out….If you ever have any type of vertigo associated with ear problems get yourself to an ER immediately.
Jul 30th, 2008
PlasticPilot
Dear John, thank you for sharing that painful experience. I know someone who had to have his tympanum perfored to balance pressure. For one YEAR, he could not take a bath, or put his head under water.
Axel, sorry for the long delay in my answer, and thank you for your tip
Jul 30th, 2008
Jon
Ear problems and kids were the two reasons I bought a Malibu. . .I’ve had three of these episodes (one on a commercial plane, two in unpressurized GA birds) and it always really bothers me. Since the commercial episode (1997), I always with Afrin Nasal Spray, which usually does the trick. Last year, however, it did not do the trick, and I had to descend from 10,500′ with a really stuck ear. I got it cleared partially down to about 3000 or 4000′, but from then on down it clogged, clearing with an incredibly painful pop when i got to the ground. For a week that ear was sensitive to sounds and painful. My doctor thought there may be a small tear, but nothing major. For the next 6 months, that ear “clicked” when it equalized.
I also cancel flights at any sign of congestion, which has been 3-4 since 1997, so it’s really not a huge impact to the flying schedule or business schedule.
I flew today after three weeks on the ground due to a viral sinus infection that is going around out here. Ears were finally cleared a couple of days ago, but even so there was some pain when equalizing, so even tiny bits of congestion can really mess this delicate system up.
My experience makes me surprised that this is not a bigger deal on commercial planes. I fly a ton for business, and I have rarely heard of any problems. When I had my commercial issue in 1997, the flight attendants had no idea how to help . . .odd.
Carry Afrin, and don’t take chances.
Jul 31st, 2008
PlasticPilot
Thank you Jon for sharing. I guess that the flight attendants had no idea to help you because if the spray does not work, the only solution would be to diminish the descent rate, which means interrupting the approach. Not something an airline captain is likely to do for a single passenger with ear problem.
Jul 31st, 2008
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