Several years back when I was returning from an overseas holiday, I had the most excruciating pain in my ears and head as we descended back into Sydney. Days earlier, I had developed a cold and didn't think much of it at the time. It wasn't until the pain struck me that I realized how bad flying can be when you are congested. Sometimes people develop pain in their ears during air travel because of an unequal pressure build up on either side of the eardrums. This is noticed most during takeoff and landing.
 
What is happening?
The middle ear (space behind the eardrum) is filled with air and connected to the nose through a channel called the Eustachian Tube. During flight, the air pressure in the sinuses and middle ear need to be equal with the cabin pressure inside the plane. As the plane ascends and descends, the pressure changes within the ear. If you have an ear infection or anything which causes a blockage in your Eustachian Tube, this restricts the ability for the middle ear to reach equilibrium, resulting in pain. 

Things such as colds, allergies, ear or sinus infections can result in an inability to equalize the ears. 

Symptoms
Although pain is the main symptom experienced, sometimes pressure change can cause tinnitus (“ringing” or “buzzing” sounds in the ears), vertigo (dizziness/imbalance) or hearing loss. In very severe cases, perforation of the eardrum may even occur. 

What to do?
Typically, most medical professionals would recommend avoiding flying while you have any active infection to reduce your chances of complications and pain.

If flying is unavoidable, then there are several tips that may help:
⦁ Sucking on lollies: swallowing, yawning or chewing can assist in allowing air to flow up the Eustachian Tube more easily. Chewing gum can also help. For younger children and babies, feeding, drinking or giving them a dummy will encourage them to swallow. 
⦁ Valsalva Manoeuvre: this technique can assist in equalizing the ears. Breathe in, then breathe out gently with your mouth closed and pinching your nose. By not allowing the air to escape, it’ll be pushed into the Eustachian Tube and you’ll feel your ears “pop” as air rushes in. This technique can be repeated whenever you feel any ear discomfort. 
⦁ Saline nasal sprays: can assist in keeping the nasal passages clear of mucus. By keeping the nasal passages clear, this may assist in keeping the Eustachian Tube clear. 
⦁ Air pressure-regulating earplugs: can be purchased from pharmacies and at the airport. These slow the rate of air pressure change on the eardrums, reducing the chances of a build up in pressure. 
⦁ Nasal balloons: these balloons can be blown up with your nose (blocking one nostril at a time and blowing through the other) and have been found to help relieve pain during flights and unblock ears. These can also be purchased from chemists.
⦁ Antihistamines: can be taken ahead of time to reduce the amount of mucus you make.
⦁ Decongestants: can assist in relieving the blockage by drying up the nose. Both oral medication and nasal sprays can assist.
⦁ Over-the-counter pain relievers: can help control discomfort.

For me, I think I'll have to pack some chewing gum next time I fly. 

This information is strictly to be used as a guide only; please consult for doctor or other professional health care provider for specific medical advice regarding your situation. 

All children born in Australia are required to undertake a comprehensive hearing assessment within the first few weeks of birth (eg NSW has the SWISH [State Wide Infant Screening Hearing] Program) which allows for the early identification of any congenital hearing difficulties and encourages prompt intervention for these children. Some children may be more likely to experience hearing loss, especially those:

• Born prematurely
• Requiring NICU placement
• Who took certain medications when younger
• With a known family history of childhood hearing difficulties

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Even if children passes this newborn test, they can still develop hearing problems throughout childhood. There are multiple causes of hearing loss in children, many of which can be corrected through medical intervention (eg wax or fluid buildup). Some signs of hearing difficulties to be aware of may include:

• Delays with their speech and language development
• Lack of responses to sounds or speech
• Persistent or frequent fluid in the middle ear/ear infections
• Behavioral concerns
• Balance issues
• Unclear speech

It is recommended that children have their hearing tested regularly during childhood and throughout their schooling life (with some schools even requiring a base-line test to be completed before a child can start kindergarten). Rates of hearing loss for school-aged children in Australia have been found to be between 3.4% and 12.8% (1) where even a mild undiagnosed hearing impairment can significantly influence their academic outcomes (and employment prospects) as well as their ability to develop language, speech, emotional and social connections.

If you are in any way concerned with your child’s hearing ability, further investigation may be warranted. Feel free to contact the clinic to arrange a full pediatric hearing assessment with one of our qualified audiologists.

(1) Choi, S.M.R., Kei, J., & Wilson, W.J. (2016). Rates of Hearing Loss in Primary School Children in Australia: A Systematic Review. Speech, Language and Hearing. doi: 10.1080/2050571X. 2016. 1259199