Air travel and tinnitus Expert audiologist explains how to manage symptoms during flights

Air travel and tinnitus: Expert audiologist explains how to manage symptoms of ringing in the ear during flights

Tinnitus affects a number of people’s lives daily, with many struggling to cope with the condition.

Tinnitus itself is when a person can hear a noise that no one else can hear with no external source of the sound. This means that only you can hear the sound and there is nothing external to the human body making the noise.

There is no set rule about what that sound will be with the following being the most common:

A low pitch humming sound
A high pitch whistle
Buzzing
Clicking
Hissing
Throbbing
Music

Below, Katie Ogden, audiologist and Training Manager for hearing ReSound in North-West Europe, highlights how and why air travel can impact sufferers of tinnitus, and how they can manage their symptoms ahead of any travel plans they have booked this Summer.

How does air travel impact our hearing?

To understand the effects of flying on the ears it’s useful to be aware of the physiological changes that occur starting with the general function of the ear.

As an organ the overall purpose of the hearing function of the ear is to convert sound waves into electrochemical impulses for the brain to process. The ear is made up of three main parts: the outer ear, the middle ear and the inner. The outer ear consists of the ear canal which funnels the sound waves to the eardrum. At this point the middle ear takes over. It’s a cavity coated with mucus consisting of the three little bones - the maleus, incus and stapes (or the hammer, anvil and stirrup).

The little bones use kinetic energy and work like levers to transmit the energy created by the vibrating eardrum to pump the fluid around the inner ear starting the necessary actions for the nerve impulse to be created for the brain to process.

The important thing to remember is that the middle ear portion is an airtight cavity linked to the nasopharynx (at the back of the throat) by the Eustachian tube. The Eustachian tube is essentially a valve that opens and closes and often this is a subconscious action enabled by chewing, yawning and swallowing. Some people can initiate this action consciously by ‘clicking’ their jaw. It is the role of the Eustachian tube to equalise the fluid and pressure in the middle ear. However, if there is an excess of fluid due to a dysfunction in the Eustachian tube then there is a potential for infection. Through the restriction in movement of the eardrum or those little bones (the ossicles) hearing loss can occur.

When you are on a flight, a disruption in pressure occurs and the Eustachian tube does not react quickly enough. Then we get the feeling of pressure, sound becomes muffled due to the restricted movement of the eardrum and when the Eustachian tube reacts, we get the feeling of our ears ‘popping’. This is simply the pressure releasing from the middle ear and is often painless, quick and for frequent fliers to be expected.

Why can tinnitus symptoms worsen on a flight?

Should the Eustachian tube fail to do its job for any reason (we call this Eustachian tube dysfunction) then there is a possibility that tinnitus can be heightened, but this tends to be temporary for most.

In more extreme cases the ‘ear popping’ experience on a plane can be painful, yet when this occurs it tends to be because of a rapid descent during the flight, which is rare in itself. If we also consider the cycle of tinnitus, it feeds off of stress which in turn feeds the tinnitus and so on.

For those that experience tinnitus and link this to stress or anxiety and have the same feelings towards flying then it is logical that either building up to, or during a flight their tinnitus appears louder.

Tinnitus is an incredibly individual experience and I have come across a small number of tinnitus sufferers who experience lower levels of tinnitus when flying due to the masking of the louder engine noise on the plane.

It is important to remember that even those with chronic tinnitus will likely not experience any changes of their tinnitus on flights and those that do, it is commonly temporary, but should you have prolonged effects because of a flight seek advice from a heath or hearing care professional.

Tips for managing the symptoms of tinnitus ahead of & during the flight

For those that find the engine noise distressing, the seats in front of the wing tend to be quietest, and the use of soft ear plugs can also help.

Personally, I find listening to music most relaxing and distracting, as well as anything that helps to distract from the engine noise. But do keep an eye on volume levels, you don’t want the volume too loud causing a temporary threshold shift (temporary noise induced hearing loss), so keep all headphone volume levels at a safe and reasonable level.

If you do wear headphones or soft ear plugs on a flight, remember to follow instructions from the onboard cabin crew and only put these in when directed and take them out when asked. Usually for landing and take off we get asked to remove them.

If the sound of the engines is not a problem, then avoid using any earplugs as blocking external sound can increase the sound of tinnitus, for most tinnitus is commonly an issue in quieter places because we have less environmental noise to mask it. If you have been fitted with hearing aids or wearable noise generators, then wear these during the flight, too. If the noise of the engines does seem a little loud with the hearing aids, then just turn them down a little rather than take them out.

For those who are anxious about flying which in turn heightens the tinnitus, look into the option of breathing and relaxation exercises, both in the build up to flying and during, this will help to keep you calm and bring down the stress levels keeping the tinnitus nice and low. In more severe cases, have a chat with the GP about other available options.

For those that find the pressure change an issue, sucking on a boiled sweet of some kind or chewing gum can help as it causes the Eustachian tube to continue to open and close equalising that pressure.

But hopefully for those most anxious about the effects of flying on their tinnitus or hearing, education and knowledge is power. Any effects are honestly usually temporary, and most will suffer no difference at all. Tinnitus should not be a barrier to you taking that trip because like tinnitus in everyday life it can be managed. The ear ‘popping’ sensation is to be expected and part of a natural bodily function. However, if you do have any questions or concerns, have a chat with your health or hearing professional and they can always give further advice.