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Decoded: Why Low Air Pressure Caused Ear Bleeding on Jet Airways

What happens to your ears when the air pressure dramatically changes?

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We’ve all been through it. You settle down in your flight and soon after it takes off, your ears pop. Normally, you’ll do some basic breathing exercises, try and swallow, bust out some some yoga moves, and eventually your hearing returns to normal.

It happens because the air pressure on a flight is usually lower than that of the surface. And this is when airplanes are pressurised.

Imagine if some mistake, some malfunction, prevents that cabin pressure from being maintained.

Last week, many passengers of a Jet Airways 9W 697 flight from Mumbai to Jaipur, took to social media to narrate their mid air horror. Almost 30 passengers had ear and nose bleed and the flight had to turn back. All because someone forgot to turn on the bleed switch, that maintains the cabin pressure as the flight takes off.

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Imagine you were a passenger on that flight...

Dr Gaurav Chaturvedy, Director, Department of ENT , Jaslok Hospital, and Dr Dillon Dsouza , Consultant ENT and Head and Neck surgeon in Mumbai, explain:

You’ve boarded the flight and settled in. The doors are shut and the aircraft becomes a pressurised chamber. Except, here the mechanism has failed to kick in.

While the flight is still on the ground, the air pressure is similar to that of the surface air. You don’t feel much.

The flight takes off and there is rapid change in air pressure.

Here’s how your ear works on a normal day

There is a membrane lined tube about the thickness of a pencil lead, that connects the back of the nose to the ears. This tube is called Eustachian tube. On one side if the tube we have a space surrounded by bone and closed off from the outside world by your ear drum. On the other side is a space that is open to the outside through the nose and mouth.

The closed space in the ear is lined by a membrane which constantly absorbs air and this air is replaced from the Eustachian tube. Thus air pressure outside the ear drum and inside the space remains equal.

But, it wasn’t a normal day...

As soon as the flight took off, there was a rapid difference in air pressure. The negative air pressure lead to the Eustachian tube getting blocked.

This is because if the air in the middle ear is absorbed but not replaced, a vacuum forms which pulls the eardrum inwards, causing a block. The stretching of the drum causes pain.

It got worse for some.

The vacuum that was created due to the imbalance of air pressure not only stretched the drum, it also pulled in fluids from the blood vessels that line up your ear.

The middle ear, once flooded, needed a way out. It ruptured the eardrum, leading to the discharge of the fluid from the ear and nose.

Oxygen masks were deployed that help passengers breathe while the flight turned around. Normally, the oxygen lasts 20-25 minutes, by then the aircraft had landed and passengers attended to.

If there was a heart or lung patient on the flight, or someone suffering from sickle cell anemia, the consequences could have been much worse.

On a regular flight, do this to ease the symptoms

Dr Dillon explains:

  • Swallowing unblocks the tubes by activating muscles that open the Eaustachian tube. Chewing gum or sucking on hard candies helps this process.
  • Yawning works better than swallowing
  • Pinch the nose shut, close the mouth and very gently blow air into the nose from the mouth.
  • If the pain and block persists, see a doctor immediately to get decongestant nasal drops and spays to open the tubes before fluid builds up in the ears.

In rare cases if the buildup of fluid in the ear is too much, the doctor may make a tiny puncture in the ear drum to release it. If the problem is recurrent, tiny plastic or metal tubes are inserted into the ear drum to equalise the pressure. These are called grommets and fall out when the Eustachian tube function recovers.

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How can you help the babies?

In babies, explains Dr Chaturvedy, the Eustachian tube is shorter and narrower. And babies can’t follow commands.

Sucking on a pacifier or feeding bottle during takeoff or landing opens the babies Eustachian tubes. Feed during flight and don’t allow the child to sleep during takeoff and landing and hold them in the upright position.

Dr Dillon says, for people with chronic problems, nasal decongestant drops and sprays can be used to open the tubes during take off and landing.

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