Atmospheric pressure decreases with increasing altitude. During navigation, as the aircraft rises or lands, the air pressure in the cockpit changes accordingly, and the gas in the air-containing chamber expands or shrinks. In general, if the Eustachian tube is well ventilated, the pressure inside and outside the tympanic membrane can be kept in balance through the adjustment of the Eustachian tube and the active ventilating action done artificially when the aircraft is ascending or descending. If the pressure inside and outside the middle ear cavity cannot be balanced quickly, various syndromes will arise, collectively known as air pressure injury, and injuries to the middle ear cavity are called aviation otitis media. It can also occur during diving operations, low-pressure cabin work, and hyperbaric oxygen therapy. Etiology: Abnormal function of the eustachian tube (upper respiratory tract infections, rhinitis, sinusitis, nasal and nasopharyngeal tumors, etc.), changes in aircraft altitude, and excessive aircraft descent speed can all lead to the onset of the disease. In addition, sleeping passengers, unconscious patients, and overly focused crew members are also susceptible to ear pressure injuries. Self-perceived symptoms include blockage in the ear, tinnitus, ear pain, hearing loss, and vertigo. The severity of these symptoms varies, and can be characterized by tympanic membrane congestion and invagination, tympanic ventricular effusion (thin, golden-yellow plasma discharge) or tympanic ventricular hemorrhage (rupture of mucosal vessels and accumulation of fresh blood in the tympanic ventricle), and in severe cases, tympanic membrane rupture. Prevention: During the descent, swallow, chew and yawn more often. If you feel that the symptoms are still not eliminated, you can pinch your nose with your thumb and index finger, close your mouth tightly and exhale forcefully, so that the airflow can rush through the eustachian tube into the middle ear air cavity and eliminate the symptoms such as ear stuffiness, ear heaviness and ear pain. If you have a cold or an abnormal function of the eustachian tube, it is best to wear Alpine
flyfit earplugs (flight pressure relief earplugs) to relieve the pressure generated during the lift. Treatment: The sooner you treat aviation otitis media, the better and easier the treatment will be. Swallowing, chewing, yawning, etc. are possible during treatment. Vasoconstrictors such as ephedrine can be applied to the nose; tympanic membrane puncture and aspiration in aseptic condition is advisable for those who have fluid and blood in the tympanic chamber; tympanic membrane perforation can be treated by plugging the external ear canal with sterile cotton balls to keep it dry, and tympanoplasty is feasible for those who cannot heal themselves. In cases of repeated aviation otitis media, the cause should be sought and removed.