Middle ear pain and trauma during air travel

Changes in air pressure during flying can cause ear-drum pain and perforation, vertigo, and hearing loss. It has been estimated that 10% of adults and 22% of children might have damage to the ear drum after a flight, although perforation is rare. Symptoms usually resolve spontaneously. We conducted a systematic review and aimed to answer the following clinical question: What are the effects of interventions to prevent middle ear pain during air travel? We searched: Medline, Embase, The Cochrane Library and other important databases up to April 2007 (Clinical Evidence reviews are updated periodically, please check our website for the most up-to-date version of this review). We included harms alerts from relevant organisations such as the US Food and Drug Administration (FDA) and the UK Medicines and Healthcare products Regulatory Agency (MHRA). We found 4 systematic reviews, RCTs, or observational studies that met our inclusion criteria. We performed a GRADE evaluation of the quality of evidence for interventions. In this systematic review we present information relating to the effectiveness and safety of the following interventions: nasal balloon inflation, oral pseudoephedrine, and topical nasal decongestants.