When the air is passing through the Eustachian tube, it is normal that the atmospheric pressure in the middle ear equals the pressure in the outer ear. But, if there is a significant inconsistency, the force that is generated due to the uneven pressures can damage the eardrum; this is known as barotrauma.
Barotrauma often occurs when a person with an infection in the nose or throat, such as a strong cold, is on the plane. During the flight, the atmospheric pressure in the cabin (and therefore in the outer auditory corridor) is lowered to a pressure of 2000 m. The air usually drops from the middle ears to the Eustachian tube, and comes out through the nose or mouth to equalize the pressure. Even when the catarrh or pus are blocking this tube, the pressure of the air that comes out allows him to ”penetrate” through the fluid. Barotrauma occurs when the air pressure increases immediately before the landing. Sometimes, the air can not be returned through the blocked Eustachian tube to the middle ear and, therefore, the eardrum will be pushed inside.
Barotrauma is also common among divers who emerged abruptly from the depth without prior pressure equalization.
Symptoms of barotrauma include earache (sometimes very strong), ear clogging, hearing loss, a mild dizziness and ”ringing” in the ear. Symptoms usually disappear after a few hours.
What to do?
If you have a nose or throat infection, and you cannot avoid a plane trip, take decongestants with you. In addition, suck candies to stimulate swallowing as much as possible. It usually holds Eustachian tube open and prevents the problems. If you think you have barotrauma, and you have the symptoms for more than 24 hours, contact a doctor who can perforate the eardrum to allow the fluid to leak out of the middle ear. This perforated eardrum does not need a special treatment; it will recover by itself after a week or so.