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FAQs on E.N.T.

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What causes blocked ears and Eustachian tubes?

The Eustachian tube can be blocked, or obscured, for a variety of reasons. When that occurs, the middle ear pressure cannot be equalized. The air already there absorbs and a vacuum occurs, sucking the eardrum inward. Such an eardrum cannot vibrate naturally, so hearing sounds muffled or blocked. Also, the stretching of the eardrum can be painful. If the tube remains blocked for a period of time, fluid (like blood serum) will seep into the area from the membranes in an attempt to fill up the ear to overcome the vacuum. This is called “Fluid in the ear”, serious otitis or aero–otitis.

The most common cause for a blocked Eustachian tube is the “Common cold”. Sinus infections and nasal allergies (e.g. hay–fever) are also frequent causes. This is because the membranes that line the Eustachian tube are similar to and continuous with nasal membranes. Consequently, a stuffy nose leads to stuffy ears because the swollen membranes block the opening of the Eustachian tube.

Another cause of blocked Eustachian tubes is infection of the middle ear which creates swollen membranes. Children are especially vulnerable to blockages as their Eustachian tubes are narrower than adults.

How can Air Travel cause problems?

Air travel is sometimes associated with rapid changes in air pressure. To maintain comfort, the Eustachian tube must function properly, that is, open frequently and widely enough to equalize the changes in air pressure. This is especially true when the airplane is coming down for a landing, going from low atmospheric pressure down closer to earth where the air pressure is higher. In the early days of airplanes with open cabins and cockpits, this was a major problem to flyers. Today’s aircraft are pressurized so that air pressure changes are minimized. Even so, some changes in pressure are unavoidable, even in the best and most modern airplanes. Actually, any situation in which rapid altitude or pressure changes occur creates the problem. You may have experienced it when riding in elevators of tall buildings or when diving to the bottom of a swimming pool. Deep sea divers are taught how to equalize their ear pressures; so are pilots.

How do you unblock your ears?

The act of swallowing activates the muscle that opens the Eustachian tube. You swallow more often when you chew gum or let mints melt in your mouth. These are good practices, especially just before and during descent. Yawning is even better. It is a stronger activator of that muscle. Be sure to avoid sleeping during descent, because you may not be swallowing enough to keep up with the pressure changes. (The flight attendant will be happy to awaken you just before descent.)

If yawning and swallowing are not effective, the most forceful way to unblock your ears is as follows:
  1. Pinch your nostrils shut.
  2. Take a mouthful of air 1.
  3. Using your cheek and throat muscles, force the air into the back of your nose as if you were trying to blow your thumb and fingers of your nostrils.
When you hear a loud pop in your ears, you have succeeded. You may have to repeat this several times during descent. Babies cannot intentionally pop their ears, but may do so if they are sucking on a bottle or pacifier. Feed your baby, and do not allow him to sleep during descent.

What precautions should you take?

When inflating you ears, you should not use force from your chest (lungs) or abdomen (diaphragm) which can create pressures that are too high. The proper technique involves only pressure created by your cheek and throat muscles.

If you have a cold, a sinus infection, or an allergy attack, it is best to postpone an airplane trip. Also, if you recently have undergone ear surgery, consult with your surgeon on how soon you may safely fly.
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