When we race through a tunnel by train, or take off and land by plane, we often feel pressure on our ears. This is a sign of what sensitive organs our ears are. A little pressure in the ear is not dangerous, just uncomfortable. But what exactly happens in the ear when the pressure is felt on the ear?

In the middle ear, behind the eardrum, is the so-called tympanic cavity, an air-filled space that contains, among other things, the ossicles. The tympanic cavity passes through a tubular connection into the back pharynx. This connection is called the eustachian tube (also called the ear trumpet or the tuba auditiva). It adjusts the air pressure in the middle ear to that of the environment. When we yawn or swallow, the eustachian tube usually opens, which causes an air pressure equalization. In this way, the eardrum has the same pressure on both sides and can function optimally. Many people are familiar with this pressure: they feel an uncomfortable feeling in their ears and have to swallow repeatedly to equalize the pressure on the eardrum.

The eardrum lies deep in the ear canal. It is elastic, transmits the vibrations of the sound to the sensitive organs of the middle and inner ear - and closes the ear airtight. If for example the air pressure is changed by speed or height, there are different pressure conditions outside and inside the ear; this causes ear pressure. The eardrum bulges uncomfortably due to the overpressure or underpressure in the ear. It feels like your ears are closing. We involuntarily have to bring about pressure equalization in the ear. This happens through air equalization via the eustachian tube. This tube connects the inside of the ear with the nose and throat.

Health effects can result if you have a bad cold and the eustachian tube becomes blocked with mucus. In such cases, air and fluids can build up in the ear, which can temporarily impair hearing. In such situations, the risk of developing infections in the ear also increases. This is particularly common in young children, as their eustachian tubes are more likely to clog.

If the feeling of pressure in the ear occurs without external influences, an infection is usually the cause. Because the earache pressure and also the feeling of the closed ear also arise when the eustachian tube is blocked, for example, by the increased formation of mucus from a cold or an allergy (e.g. hay fever). In contrast to changing air pressure from the outside, pressure is often only created on one ear. Regardless of whether it is one-sided or in both ears: pay attention to typical, accompanying infection symptoms such as pressure in the head and ears and possibly fever and body aches. Ear pressure is often the first symptom of:

• An approaching cold
• Otitis media
• An ear canal infection
• Rarely a hearing loss
• Very rarely from Ménière's disease
• Anxiety

Indeed, the feeling of a full ear is often interpreted as the subjective symptom of endolymphatic hydrops, which affects and is a key phenomenon of Ménière's disease. It is due to the increase in a liquid (endolymph) which is contained, in very small quantities, within the bodies responsible for controlling balance (labyrinth). The endolymph increasing in volume causes tinnitus, a reduction in hearing ability but also dizziness. This symptomatic triad, together with the feeling of a full ear, characterizes Ménière's syndrome.

It is therefore clear that the sensation of pressure in the ear must always be carefully evaluated by the specialist doctor who, through a direct vision of the ear - otoscopy - can identify the cause of the disorder and steer you towards proper therapy.

If there is no pressure, but your hearing performance becomes increasingly poor, there may be a completely harmless, simple cause: a clogged feeling in the ear and dull hearing can be caused by plugs of ear wax forming in the ear. A banal earwax plug affecting the external ear is perhaps the most frequent cause of pressure in the ear. This phenomenon is the direct consequence of the presence of specific receptors (baroreceptors), in the external auditory canal,  that respond to pressure variations. The accumulation of ceruminous material and debris of the external auditory canal, when it causes a total closure of the canal, determines a consequent sensation of pressure in the ear and a reduction in hearing capacity. Hearing loss is transient because by removing the earwax, the hearing returns as it was previously. 

To loosen the plug, rinses are available in pharmacies. Your ENT doctor can remove particularly firm clogs. A less harmless cause is stress. This can be a sign of an impending hearing loss or tinnitus. If you think you have ear pressure from stress, apply the emergency brake. Use relaxation techniques (e.g. autognes training) and treat yourself to rest.

Of course, a "real" hearing loss is also possible. To check your hearing performance. you can carry out a first hearing test online here. Alternatively, your Amplifon hearing care professional will be happy to carry out a non-binding precise hearing test in your nearest branch for free. Contact an ear, nose and throat doctor to determine the causes of the decreased hearing.