Away on Business - A Travel Pain
By Michael Conlon
Reuters News
(c) 2004 Reuters Limited CHICAGO, June 17 (Reuters)

Air travel can be a pain, but when that pain involves the ears there may be something wrong that goes beyond the obvious. Persistent ear pain has caused some business travelers to give up air travel, said Dr. Jordan S. Josephson, a nasal and sinus specialist at Lenox Hill Hospital in New York, whose patients include frequent flyers. They thought the culprit was normal sensitivity to the changes in cabin air pressure, he said, and the usual home remedies - from chewing gum to swallowing hard with a closed mouth - didn't help.

The problem, as it turned out, was sinus-related. "A lot of people need to look for someone who understands sinus and ear physiology," Josephson said in an interview. Allergies or infections there can cause swelling in the Eustachian tubes, which connect the middle ear and the back of the nose, and significant ear problems may result. "I've had patients who were treated by doctor after doctor for ear problems, but no one ever addressed their sinus problems," he added. If left untreated, problems can include hearing loss, dizziness and a ringing in the ear.

"The first thing you need to do is make a proper diagnosis," which may include a CAT scan, Josephson said. After that, the first treatment is medical - antibiotics or nasal sprays, antihistamines that treat allergies, or agents that reduce inflammation. If a problem persists, surgery is an advanced surgical techniques. Josephson uses endoscopic surgery, which can be performed with only a "twilight" anesthesia such as that used in some other outpatient procedures.

He also says that some kinds of ear plugs offer relief in cases where the sinus is not involved. For infants and smaller children who, because of their size, suffer disproportionately from cabin pressure changes, he recommends plenty of liquids and using a pacifier. For older children, blowing up a balloon during a flight can help.