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Changes in air pressure due to flying or diving can lead to a feeling of pain and pressure in the ears as the eardrum bulges towards the area of lower pressure. Whenever the air pressure of your surroundings changes, the air pressure inside your ear needs to adjust. To keep air pressure inside and outside of the eardrum equal, we have “drainage” tubes (the eustachian tubes) which connect the middle part of the ear to the back of the nose and throat.
When an aeroplane is descending, the surrounding air pressure becomes higher nearer the ground and this pushes the eardrum inwards. The pressure inside the middle ear needs to rise rapidly to relieve this, by opening the eustachian tube and lowering pressure inside the ear to equalize with the outside pressure. If there is any blockage of the eustachian tube, air is prevented from entering the middle ear, the eardrum becomes stretched and more tense causing pain.
Our ears produce small amounts of fluid which normally drains down the eustachian tubes. Yawning, chewing or swallowing helps open the tube to allow air into the middle ear. Problems occur if the tube doesn’t drain efficiently and is blocked with mucus causing congestion.
If there is congestion in the ear due to an ear infection, throat infection, allergies or any condition which causes extra mucus in the eustachian tube, this can prevent your ears from equalising the pressure effectively. This leads to a build-up of pressure where ears feel blocked, painful and can cause hearing to become muffled.