When the eardrum is retracted by a change of atmospheric pressure while the eustachian tube is blocked, the condition is known as barotitis media. It is painful and usually reduces hearing temporarily, but it often responds easily to treatment and is seldom very serious. If the changes of air pressure are very great or if the eustachian tube is extremely blocked, the pressure may cause bleeding of the little capillaries in the middle ear. The blood filling the middle ear acts as a sound barrier, and there may be a considerable hearing loss, as well as a peculiar feeling of being under water. The physician diagnoses barotitis media by direct observation of the condition using an otoscope.
Some people find that chewing gum or yawning helps equalize the pressure in their ears.
If air travel with a stuffy nose is unavoidable, nasal decongestants or anti-histamines should be taken an hour before takeoff and, on long flights, again an hour before landing.