Ear clearing
Encyclopedia
Ear clearing or clearing the ears is any of various maneuvers to equalize the pressure in the middle ear
with the outside pressure
, by letting air enter along the Eustachian tube
s, as this does not always happen automatically when the pressure in the middle ear is lower than the outside pressure. This need can arise in scuba diving
, skydiving, fast descent in an aircraft
, fast descent in a mine cage
, and being put into pressure in a caisson
or similar pressure-bearing structure.
People who do intense weight lifting, like squats, may experience sudden conductive hearing loss due to air pressure building up inside the ear. They are advised to engage in an ear clearing method to relieve pressure, or pain if any.
No single method is considered superior in equalization of the middle ear pressure. Using alternative techniques may improve the success individually when a technique fails.
. This damages hearing, and if this occurs underwater, cold water in the middle ear chills the inner ear
, causing vertigo
. The pressure difference can also cause damage to other body air spaces, such as the paranasal sinus
es. This can also be caused by damaged sinus
ducts.
To allow successful equalization when diving, it is important that the diving suit
hood does not make an airtight seal over the outside ear hole, and that earplugs are not worn. It is not recommended to dive when a eustachian tube is congested or blocked, e.g. with the common cold
, as this may cause what is known as a reverse block. Descent is uninhibited as the valsalva maneuver may still clear the eustachian tubes temporarily by force, but during ascent a blockage may stop the air in the middle ear (which is now at depth pressure) from escaping as the diver ascends. The eardrum then bursts outwards, causing the same hazards as with an ordinary burst eardrum, such as cold water in the middle ear deranging the working of the sense organs of balance in the inner ear.
) has produced a series of exercises using the tongue and soft palate
to assist a diver in clearing their ears by these techniques. These recommendations were based on work done at the Médecine du sport, Bd st Marcel, Paris.
With practice it is possible to close the nostrils hands-free by contracting the compressor naris muscles.
Middle ear
The middle ear is the portion of the ear internal to the eardrum, and external to the oval window of the cochlea. The mammalian middle ear contains three ossicles, which couple vibration of the eardrum into waves in the fluid and membranes of the inner ear. The hollow space of the middle ear has...
with the outside pressure
Ambient pressure
The ambient pressure on an object is the pressure of the surrounding medium, such as a gas or liquid, which comes into contact with the object....
, by letting air enter along the Eustachian tube
Eustachian tube
The Eustachian tube is a tube that links the nasopharynx to the middle ear. It is a part of the middle ear. In adult humans the Eustachian tube is approximately 35 mm long. It is named after the sixteenth-century anatomist Bartolomeo Eustachi...
s, as this does not always happen automatically when the pressure in the middle ear is lower than the outside pressure. This need can arise in scuba diving
Scuba diving
Scuba diving is a form of underwater diving in which a diver uses a scuba set to breathe underwater....
, skydiving, fast descent in an aircraft
Aircraft
An aircraft is a vehicle that is able to fly by gaining support from the air, or, in general, the atmosphere of a planet. An aircraft counters the force of gravity by using either static lift or by using the dynamic lift of an airfoil, or in a few cases the downward thrust from jet engines.Although...
, fast descent in a mine cage
Mining
Mining is the extraction of valuable minerals or other geological materials from the earth, from an ore body, vein or seam. The term also includes the removal of soil. Materials recovered by mining include base metals, precious metals, iron, uranium, coal, diamonds, limestone, oil shale, rock...
, and being put into pressure in a caisson
Caisson (engineering)
In geotechnical engineering, a caisson is a retaining, watertight structure used, for example, to work on the foundations of a bridge pier, for the construction of a concrete dam, or for the repair of ships. These are constructed such that the water can be pumped out, keeping the working...
or similar pressure-bearing structure.
People who do intense weight lifting, like squats, may experience sudden conductive hearing loss due to air pressure building up inside the ear. They are advised to engage in an ear clearing method to relieve pressure, or pain if any.
Methods
The ears can be cleared by:- YawnYawnA yawn is a reflex of simultaneous inhalation of air and stretching of the eardrums, followed by exhalation of breath. Pandiculation is the act of yawning and stretching simultaneously....
ing which helps to open the eustachian tubes; - SwallowingSwallowingSwallowing, known scientifically as deglutition, is the process in the human or animal body that makes something pass from the mouth, to the pharynx, and into the esophagus, while shutting the epiglottis. If this fails and the object goes through the trachea, then choking or pulmonary aspiration...
which helps to open the eustachian tubes; - The "Frenzel maneuverFrenzel maneuverThe Frenzel Maneuver is named after Herman Frenzel . The maneuver was developed in 1938 and originally was taught to dive bomber pilots during World War II. The maneuver is used to equalize pressure in the middle ear...
": using the rear part of the tongue and throat muscles;. Another description of the method is to close the nostrils, and close the back of the throat as if straining to lift a weight. Then make the sound of the letter "K." This pushes the back of the tongue upward, compressing air into the openings of the eustachian tubes. - "PolitzerizationPolitzerizationPolitzerization, also called the Politzer maneuver or method, is a medical procedure that involves inflating the middle ear by blowing air up the nose during the act of swallowing...
": a medical procedure that involves inflating the middle ear by blowing air up the nose during the act of swallowing; - The "Toynbee maneuver": pinching the nose and swallowing. Swallowing pulls open the eustachian tubes while the movement of the tongue, with the nose closed, compresses air which passes through the tubes to the middle ear.
- The "Valsalva maneuverValsalva maneuverThe Valsalva maneuver or Valsalva manoeuvre is performed by moderately forceful attempted exhalation against a closed airway, usually done by closing one's mouth and pinching one's nose shut...
": pinching the nose and closing the mouth and trying to breathe out through the nose. If the hand cannot reach the nose, it is possible to learn to pinch the nose shut by the action of two small face muscles called compressor naris. This is the first technique normally taught, but needs to be performed gently to lessen side-effects. - The "Lowry Technique". A combination of Valsalva and Toynbee: pinching the nose to close the nostrils, and blow and swallow at the same time.
- The "Edmonds Technique". While tensing the soft palate (the soft tissue at the back of the roof of the mouth) and throat muscles and pushing the jaw forward and down, do a Valsalva maneuver.
- Voluntary opening of the eustachian tubes: Voluntary opening of the tubes: Voluntary Tubal Opening:(French: béance tubaire volontaire (BTV) ) is a method of equalising or clearing the ears described by doctor Georges Delonca and used in scuba divingScuba divingScuba diving is a form of underwater diving in which a diver uses a scuba set to breathe underwater....
and freediving. It aims to rebalance the pressurePressurePressure is the force per unit area applied in a direction perpendicular to the surface of an object. Gauge pressure is the pressure relative to the local atmospheric or ambient pressure.- Definition :...
between the external ear and middle ear. The subject must either exercise a voluntary control of the Tensor veli palatini muscles opening the eustachian tubes, or move the jaw to open the tubes when necessary. This is less easy to execute than the Valsalva maneuverValsalva maneuverThe Valsalva maneuver or Valsalva manoeuvre is performed by moderately forceful attempted exhalation against a closed airway, usually done by closing one's mouth and pinching one's nose shut...
, but the BTV is the gentlest method to clear the ears. However, not all divers can perform this manoeuvre. It may be necessary to engage in ear training exercises to train the muscles to perform this manoeuvre. Another description of the method is to tense the muscles of the soft palate and the throat while pushing the jaw forward and down as if starting to yawn. This should pull the eustachian tubes open.
No single method is considered superior in equalization of the middle ear pressure. Using alternative techniques may improve the success individually when a technique fails.
Precautions
The pressure difference between the middle ear and the outside, if not released, can result in a burst eardrumEardrum
The eardrum, or tympanic membrane, is a thin membrane that separates the external ear from the middle ear in humans and other tetrapods. Its function is to transmit sound from the air to the ossicles inside the middle ear. The malleus bone bridges the gap between the eardrum and the other ossicles...
. This damages hearing, and if this occurs underwater, cold water in the middle ear chills the inner ear
Inner ear
The inner ear is the innermost part of the vertebrate ear. In mammals, it consists of the bony labyrinth, a hollow cavity in the temporal bone of the skull with a system of passages comprising two main functional parts:...
, causing vertigo
Vertigo (medical)
Vertigo is a type of dizziness, where there is a feeling of motion when one is stationary. The symptoms are due to a dysfunction of the vestibular system in the inner ear...
. The pressure difference can also cause damage to other body air spaces, such as the paranasal sinus
Paranasal sinus
Paranasal sinuses are a group of four paired air-filled spaces that surround the nasal cavity , above and between the eyes , and behind the ethmoids...
es. This can also be caused by damaged sinus
Sinus (anatomy)
Sinus is Latin for "bay", "pocket", "curve", or "bosom". In anatomy, the term is used in various contexts.A sinus is a sack or cavity in any organ or tissue, or an abnormal cavity or passage caused by the destruction of tissue...
ducts.
To allow successful equalization when diving, it is important that the diving suit
Diving suit
A diving suit is a garment or device designed to protect a diver from the underwater environment. A diving suit typically also incorporates an air-supply .-History:...
hood does not make an airtight seal over the outside ear hole, and that earplugs are not worn. It is not recommended to dive when a eustachian tube is congested or blocked, e.g. with the common cold
Common cold
The common cold is a viral infectious disease of the upper respiratory system, caused primarily by rhinoviruses and coronaviruses. Common symptoms include a cough, sore throat, runny nose, and fever...
, as this may cause what is known as a reverse block. Descent is uninhibited as the valsalva maneuver may still clear the eustachian tubes temporarily by force, but during ascent a blockage may stop the air in the middle ear (which is now at depth pressure) from escaping as the diver ascends. The eardrum then bursts outwards, causing the same hazards as with an ordinary burst eardrum, such as cold water in the middle ear deranging the working of the sense organs of balance in the inner ear.
Training
Divers get training in clearing the ears before being allowed to dive. Because of the potential for side effects of the valsalva maneuver, scuba divers and free-divers may train to exercise the muscles that open the Eustachian tubes in a more gentle manner. The French underwater association (Fédération Française d'Études et de Sports Sous-MarinsFédération Française d'Études et de Sports Sous-Marins
The Fédération Française d'Etudes et de Sports Sous Marins is the main diver training organization of France and was formed in 1955. It has 160,000 members and consists of 2200 clubs. It is one of the founding members of the Confédération Mondiale des Activités Subaquatiques...
) has produced a series of exercises using the tongue and soft palate
Soft palate
The soft palate is the soft tissue constituting the back of the roof of the mouth. The soft palate is distinguished from the hard palate at the front of the mouth in that it does not contain bone....
to assist a diver in clearing their ears by these techniques. These recommendations were based on work done at the Médecine du sport, Bd st Marcel, Paris.
With practice it is possible to close the nostrils hands-free by contracting the compressor naris muscles.