Ear Barotrauma While Doing Balloon Safaris

Enjoying Kenya safari in a hot air balloon is one of the most thrilling experiences. It gives a bird’s eye view of the wildlife and the vast savannah of the game parks in Kenya. After about an hour, just about the time of descent of the balloon, along with the exhilaration, some people feel a slight discomfort or stuffiness in the ear. But it almost always goes away on landing. This uneasiness is ear barotrauma. People who suffer from congested nose due to common cold are more likely than others to feel such awkwardness.






Ear barotrauma explained

The eardrum separates the canal of the ear from the center ear. The small space behind the eardrum connects the back of the nose and throat through the Eustachian tube. Inside the ear, the air that fills the tympanic cavity is absorbed into the lining of the middle ear. Then it flows back up through the tube. This way the Eustachian tube connects the tympanic cavity with the throat and back of the nose. Ironically, this pipe also connects the middle ear to the outside world. So, the middle ear is separated from the external world by the eustachian tube anteromedially and the tympanic membrane laterally. Thus, this conduit facilitates air to enter when pressure equalization is needed. It also helps maintain and regulate air pressure by keeping the air on either side of the eardrum the same.

During balloon ride

Ear barotrauma while doing balloon safaris

Ear barotrauma while doing balloon safaris

The eardrum separates the canal of the ear from the center ear. The small space behind the eardrum connects the back of the nose and throat through the Eustachian tube. Inside the ear, the air that fills the tympanic cavity is absorbed into the lining of the middle ear. Then it flows back up through the tube. This way the Eustachian tube connects the tympanic cavity with the throat and back of the nose. Ironically, this pipe also connects the middle ear to the outside world. So, the middle ear is separated from the external world by the eustachian tube anteromedially and the tympanic membrane laterally. Thus, this conduit facilitates air to enter when pressure equalization is needed. It also helps maintain and regulate air pressure by keeping the air on either side of the eardrum the same.

Eustachian tube helps to restore equilibrium during pressure changes. It is the Eustachian tube that holds the ears in their normal state. Hence, equalization or normalization of pressure occurs through the soft tissue tube called the Eustachian tube. This extends from the middle ear space to the back of the nose.

Preventing ear barotrauma

If the Eustachian tube stays blocked, the middle ear can fill with clear fluid to try to equalize the pressure. This fluid called the serous otitis media that comes out of blood vessels lining the inner ear can only drain if the tube is open. In other words, prevention of ear barotrauma involves keeping the Eustachian tubes open. Otherwise, the pressure difference experienced during a balloon safari can create hearing difficulty and an uncomfortable feeling in the ear.

In some cases, it may bruise the eardrum or rupture the oval window and lead to a temporary hearing loss

In some cases, it may bruise the eardrum or rupture the oval window Source: Mayo Clinic

Under normal circumstances, the air pressure outside the body is most often the same as that in the middle ear. When it matches with that of the middle ear, the tympanic membrane vibrates, and we hear a clear sound. But when a balloon lands, the pressure inside the cabin rises because the weight of the air is higher on the ground. To equalize, the pressure inside the middle ear also has to increase, which means air has to travel up the Eustachian tube into the middle ear.

Eustachian tube

Eustachian tube Source: Hearing Health Associates

In case of a partial or complete blockage in the pipe due to a tumor, scarring, infection, allergy, or the common cold, air cannot pass through the middle ear. And the pressure on the outside remains different than the pressure in the middle ear. This obstruction in the tube leads to an inability to obtain equalization when the pressure changes fast during the balloon descent. In this case, the pressure differences create a vacuum, and the eardrum is stretched and sucked inward. And that is how variations in the air pressure between the outside world and the middle ear lead to discomfort, injury, and even hearing loss. In essence, ear barotrauma occurs when this tube does not function adequately.

Last resort measure

In extreme cases of ear barotrauma and if everything fails, surgery may be required and could be the best option for treatment to prevent permanent damage. This process stimulates airflow into the middle ear. People who frequently change altitudes or often fly for a living use it. The ear tube will remain in place for up to twelve months. Another option involves a tiny surgical slit cut into the eardrum that allows the pressure to equalize by removing any fluid. But this may not be a permanent solution as the slit will heal quickly.

Ear ache during balloon safari

Why do some people feel a slight discomfort or stuffiness in the ear during a balloon safari?
Some people may experience discomfort or a feeling of stuffiness in the ear during a balloon safari due to changes in air pressure. As a hot air balloon ascends or descends, the air pressure inside the balloon and the surrounding environment changes. This can cause a difference in pressure between the outside and inside of the ear, which can lead to discomfort, a feeling of fullness, or even temporary hearing loss.

How do you equalise the pressure in the ear during a balloon safari?
To help equalise the pressure in the ears, it is often recommended to do what is called the Valsalva manoeuvre. This involves gently pinching the nostrils closed while gently blowing out, which helps to equalise the pressure in the ears. It is also helpful to yawn or swallow during the ascent or descent to help equalise the pressure.

What do do if you have any concerns about your ear health pressure in the ear during a balloon safari?
Most people do not experience any discomfort during a balloon safari, and those who do usually only experience mild discomfort that quickly resolves. If you have any concerns about your ability to tolerate the changes in pressure during a balloon safari, you may want to speak with your doctor before booking your flight.

Explain barotrauma that is experienced during a balloon safari
Barotrauma is a condition that can occur when there is a difference in pressure between the inside and outside of the body. During a balloon safari, barotrauma can occur due to changes in air pressure that can affect the ears, sinuses, and lungs.

What happens when you experience barotrauma during a balloon safari?
In the ears, barotrauma can cause discomfort, pain, and temporary hearing loss. This occurs when the difference in pressure between the inside and outside of the ear causes the eardrum to stretch or even rupture. In the sinuses, barotrauma can cause a feeling of pressure or pain in the forehead, cheeks, or behind the eyes. This occurs when the difference in pressure causes the sinuses to become inflamed or even to fill with fluid. In the lungs, barotrauma can occur if air is trapped in the lung tissue and cannot escape during changes in pressure. This can cause lung tissue to rupture or collapse, which is a serious and potentially life-threatening condition.

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