The Middle Ear

The middle ear refers to a collection of bones (ossicles) and muscles which are contained within the tympanic cavity.

The Eardrum (Tympanic Membrane)

Air pressure waves are transformed into physical vibrations, which are amplified in the middle ear and transferred to the cochlea (see the diagram above).

The Ossicles

The ossicles attach the eardrum and form the ossicular chain, which is made up of 3 bones:

  • Malleus
  • Incus
  • Stapes

These bones serve as a mechanical amplifier depending on the frequencies that are entering the ear canal.

Eustachian Tube

The eustachian tube is a narrow passage that goes from the pharynx to the tympanic cavity. This passage is what allows the middle ear to remain "equalized" with the outside pressure.

Pressure Changes

During normal flight, pressure decreases during a climb and increases during a descent. The pressure changes need to be "equalized" via the eustachian tubes when these changes in pressure occur. For most healthy individuals, this will only cause a mild discomfort. However, there are many situations where a person can experience pain from these changes.

Ear Block

When the eustachian tubes become blocked, they are no longer able to transfer pressure into our out of the middle ear. This condition is referred to as ear block.

Common causes of ear block include bacterial and viral infections. This is another reason why flying while even mildly sick can be hazardous.

Symptoms Related to Ear Block

The following symptoms are common when experiencing ear block:

  • Pain
  • Vertigo
  • Disorientation
  • Headache
  • Hearing

All of these symptoms can be distracting and cause a pilot to lose focus on flying the airplane safely. Additionally, if a passenger is suffering from ear block, make sure to assist, but do not lose focus on flying.

Treatment of Ear Block

The following treatments can be effective in returning the inner ear to ambient pressure:

  • Swallowing
  • Yawning
  • Tensing muscles in the throat
  • Pinch nose and attempt to blow out through nostrils (valsalva maneuver)

Remember that suffering from ear block during a climb will most likely result in similar problems when descending.