If you feel pressure in your ear that is not relieved by yawning, coughing or swallowing, you may have an ear pressure problem. This is usually caused when the Eustachian tube connected to your middle ear has become inflamed and is creating a vacuum in your ear, which builds up pressure.
Negative Middle Ear Pressure
Colds and allergies may cause the Eustachian tube to become blocked. The Eustachian tube, a 1 ½-inch long canal that runs from the back of your nose to your middle ear, supplies air to the middle ear. It opens about once every 3 minutes when you yawn or swallow. This relieves built up pressure in your middle ear. If air cannot get into the ear through the Eustachian tube, the ear will absorb all the available air and a vacuum will form that builds pressure. It can cause a retraction of the ear drum and a negative middle ear pressure causing a fullness and pain in your ear, and sometimes even a hearing loss or ringing in your ears.
If this obstruction goes on for a time, fluid can build up in the middle ear causing an ear infection (otitis media). This happens more often in children than adults, especially when they have a cold or the flu. In a very serious case, a hole can form in the eardrum. You will know this has occurred if you have drainage from your ear. In either instance, it is important you visit your doctor. In this case, your doctor may recommend placement of tubes in the ear to relieve pressure.
Positive Ear Pressure
The opposite of this problem can occur when the Eustachian tube remains open for too long a time. This is known as abnormal patency of the Eustachian tube, where a person can hear himself breathing and other reverberations of sound. This is an annoying condition but does not cause hearing loss or ear infections.
Ear Pressure Problems and Flying
If you fly often, then you know how your ears may pop upon ascent or descent of the plane. This is just annoying for most people, but if you have ear pressure problems it can create quite a bit of discomfort. Atmospheric pressure decreases when the plane takes off, creating a decrease in pressure in the middle ear. When the plane descends, air pressure increases. If you have Eustachian tube inflammation, both ascent and descent may create increased pressure problems in your ear.
Tips for Flying
To avoid discomfort when you fly, make sure you don't have a cold or nasal stuffiness when you fly. Take a non-sedating antihistamine decongestant such as Claritin or prescription Allegra-D before you fly. (preferably, a day in advance and on the morning you are flying, or as indicated by a doctor). Also use a nasal decongestant like Afrin before you fly. Upon descent, if your ears become clogged, hold your nostrils closed and swallow to equalize the pressure in your middle ear. Also, try chewing gum to help open your Eustachian tube.
If none of this works, try a Valsava maneuver, in which you hold your nostrils closed and try to blow air into the Eustachian tube to relieve pressure. (Note: Do not perform this maneuver if you have a cold or allergies that cause chronic congestion.)
Potentially Serious Problems
Prolonged negative pressure in the middle ear can deform the eardrum or the bones of the middle ear over time. This can cause hearing loss. Inflammation and infection over the long term can erode the walls of the middle ear. You might experience hearing loss, imbalance and difficulty with facial movement on the side of the face where the ear is affected. In very rare instances, an infection can occur that enters the brain, causing meningitis or a brain abscess.
Tests for Negative Ear Pressure
Tympanometry is a test that is used to evaluate middle ear function. It will detect fluid in the middle ear, negative middle ear pressure, disruption of the walls of the middle ear and other middle ear problems. An ear, nose and throat specialist (otolaryngologist) can perform this test for you