Ear issues (Pain, ringing, tinnitus, tubes, perforations)

[Runr6730]

awfltdoc, thanks for the advice. I will get it checked out when I get back (im actually on leave right now for the holidays). The symptoms are nearly (95%) gone, but I can still hear a difference in the early morning and evening. Is this something that I should get checked out even if the symptoms go away?

[Guest awfltdoc]

I'd recommend follow up with the flt doc, but its your call if your 100% on your return to home station.

[Guest F16PilotMD]

I have been in your shoes and I remember the "fear of the flight doc" very well. That said, be very, very careful with ear blocks. What you most likely need to learn is the concept of clearing your ears EARLY in descent. That is typically forgotten in UPT b/c you're occupied with other things during the flight. It becomes second nature, just like an AGSM. If you are like many, many people (and I forgot to check where you are located) you have a chronic sinusitis or sorts and this can occur over and over again.

We all have our horror stories...the one I'll share with you is of an ear block that was kept a secret and ended up with a permanent DQ. It is likely that with your symptoms gone, the flight docs will have nothing to see or check out. It's hard to make someone who feels fine feel better. Just be careful when you start flying and clear early. If it gives you trouble, speak up in the air and seek help from the flight docs. Trust me, you won't be the first UPT stud with an ear block issue.

[Guest KoolKat]

This might be another one of those situations with differeing answers depending on whether you have your wings already or not.

'Navtastic' asked this question within the last year. You could get alot of information about this if you track down those posts.

She was already a winged navigator, but she had much success with the solution.

BENDY

[Guest CrewDawg1]

I have had a problem clearing my ears, had a surgery and will go into the alt. chamber again next week. If I still can't clear my ears, are UPT students allowed to get tubes? If so do they require a waiver?

*I did a search and was only able to find that a NAV was able to get tubes without a waiver. I am not sure if there is a diffenece for pilots.

[Guest Rage_:P]

I have had a problem clearing my ears, had a surgery and will go into the alt. chamber again next week. If I still can't clear my ears, are UPT students allowed to get tubes? If so do they require a waiver?

*I did a search and was only able to find that a NAV was able to get tubes without a waiver. I am not sure if there is a diffenece for pilots.

Anything is possible...including clearing your ears w/o a waiver

[BADFNZ]

For as long as I can remember, I've experienced pain in my ears during descent on commercial flights. I've never had trouble while flying with my PPL, I'm guessing due to the altitude. I'm sure the pain is sinus related because when I change my head position (sitting to laying down) I can feel the fluid in my ears shift. Over the years I've taken every anti-biotic in the book for other illnesses, yet this still remains. I've never had allergy problems of any sort, and this never bothers me unless I fly. I was reminded of this yesterday since I just returned from vacation. A day later, it still feels like my ears are partially "popped" and my hearing isn't back to normal yet. Everytime I yawn they return to normal a little more.

So is it common for people to experience this? Is this something that's easy to cure with the right medicine or is it more involved than that? Is there something I can do on descent to clear my ears better? More importantly, is this going to screw me come UPT?

[Guest awfltdoc]

So is it common for people to experience this? Yes. If you have eustation tube dysfunction. However, maybe your normal and are just sensitive to pressure changes. Do you know how to valsalva?

Is this something that's easy to cure with the right medicine or is it more involved than that? Maybe and Maybe. Depends on whats wrong with you.

Is there something I can do on descent to clear my ears better? Valsalva.

More importantly, is this going to screw me come UPT? You'll probably experience this in the type of flying you'll do in UPT.

Although you stated you don't have allergy problems, you mention the pain is sinus related because you can feel fluid in your ears shift. Did you have a cold or virus that you flew with?

Anyway, I suspect it may be eustation tube dysfunction. Could be due to infection, allergies, blockages such as an anotomically narrow eustatian tube or say from enlarged adenoids. This would require an evaluation by your physician to identify the problem.

[BADFNZ]

So is it common for people to experience this? Yes. If you have eustation tube dysfunction. However, maybe your normal and are just sensitive to pressure changes. Do you know how to valsalva?

Is this something that's easy to cure with the right medicine or is it more involved than that? Maybe and Maybe. Depends on whats wrong with you.

Is there something I can do on descent to clear my ears better? Valsalva.

More importantly, is this going to screw me come UPT? You'll probably experience this in the type of flying you'll do in UPT.

Although you stated you don't have allergy problems, you mention the pain is sinus related because you can feel fluid in your ears shift. Did you have a cold or virus that you flew with?

Anyway, I suspect it may be eustation tube dysfunction. Could be due to infection, allergies, blockages such as an anotomically narrow eustatian tube or say from enlarged adenoids. This would require an evaluation by your physician to identify the problem.

Thanks for the reply.

No, I've never flown with a cold, flu, or any other sort of illness. This is just some lingering thing that pops up when I fly commercially. I guess the best thing is to see a doctor before I go to OTS to see what the problem is. Is an ENT the right doctor to see for this?

I'm not familiar with valsalva, but I'm ok going to look it up now.

Edited September 26, 2007 by BADFNZ

[Guest awfltdoc]

Thanks for the reply.

No, I've never flown with a cold, flu, or any other sort of illness. This is just some lingering thing that pops up when I fly commercially. I guess the best thing is to see a doctor before I go to OTS to see what the problem is. Is an ENT the right doctor to see for this?

I'm not familiar with valsalva, but I'm ok going to look it up now.

You might want to learn how to valsalva. If this simple maneuver solves the issue, then there is no reason to see the doc. Hopefully, this is the answer. If your not sure how to do the valsalva, find a pilot around the local flying patch and ask em.

[Guest overspeed]

I understand that having tubes in your ears in the past isn't disqualifying. Is having ear tubes CURRENTLY disqualifying, or does it require a waiver?

[Guest nick4060]

Hello Im a high school senior applying for both USAFA and the AFROTC scholarship program. When I took my initial DoDMERB physical I told them I was taking Nasonex to prevent development of nasal polyps. Well...they DQed me for nasal polyps and I then tried to rebut. They allowed me to get a CT scan of my sinuses and after getting the results, they changed the DQ to 'sinusitis, acute or chronic'.

Now I assume its the 'acute' type because I dont and never had any problems with my sinuses. I have a PPL and never had any problems with pressure changes (granted 500 ft/minute descents arent very hard on the sinuses). But Ive seriously never noticed any problems. Obviously there is something up there, or they wouldnt have DQed me. Now Im pursuing a waiver to get cleared for USAFA/ROTC.

Well my question is...will this issue still be around 4 years from now when I go up for FC1. I searched the forum and noticed that surgery could be disqualifying unless its done a year in advance. So, theoretically, could I get a waiver for college, then get it fixed in college, and get a waiver for UPT? Even if I cant fly, Ill still want to be in the AF, so is this a serious enough issue to prevent me from getting commissioned? I assume if Im given a waiver to go to the academy or ROTC on scholarship, then Ill be commissionable. But I just want to be sure.

Thanks

Nick

[Guest Gumby]

I haven't been on this forum for a very long time, apologies if there's a duplicate topic but I'd appreciate any help. I'm an active-duty flyer (B-52s, Minot). A couple weeks ago I had a case of swimmer's ear but was told I was okay to fly with it and given some ear drops. Well, today I had my PHA and the flight doc said I've got a very small perforation on my left eardrum. Not sure if this is from the infection or a q-tip or what, but I won't be flying for a few months. My big question is over how often these things heal on their own. I've had ear surgeries as a child (15 years ago) and had a perforation in the same ear due to blunt force injury about 10 years ago, so I'm kind of wondering if any of that could be a complication in healing? Is this something I can expect to heal on it's own in 2 months or will something more complicated be involved. Obviously, I'll have to wait and see for sure, but it's two weeks until I can see the specialist and this is all coming as a shock. Any help would be appreciated.

Thank you

[aquajam77]

So apparently this procedure is still (relatively) new, but has anyone heard of eustachian tuboplasty? It's for Eustachian Tube Dysfunction (ETD) and helps to clear out the eustachian tube to be able to equalize the ear better.

Does the Air Force have anything on this, whether it's a DQ or not for FC I, II, or III?

Thanks

[aquajam77]

Found the answer to my own question, here it is in case anyone else needs it.

Basically you can get tuboplasty to help ear clearing issues and you can get a waiver as long as you are able to then successfully equalize properly (If I read all of this correctly)

III. Waiver Considerations.

Acute ETD/OM secondary to a transient illness (e.g. viral URI or SAR) requires no waiver but is grounding for flyers until resolution. However, chronic ETD/OM is disqualifying and requires a waiver for FC I/IA, II and III. Also any surgical procedure for correction of ETD/OM is disqualifying for FC I/IA, II and III. It is summarily accurate to emphasize that resolution of ETD/OM and adequacy of ET function are to be assessed on a case by case basis and that no one treatment or procedure, per se, will lead to waiver approval. Regardless of cause or treatment modality, ET functionality must be demonstrable for waiver authority consideration to be granted. In general, the permanent use of PE tubes in flyers is not a good idea, but it is a fact that adults tend to tolerate chronic use of PE tubes better than children. What is important is the operational necessity of using the tubes and the clinical judgment of the flight surgeon and treating otolaryngologist.

[shift]

Has anyone dealt with vertigo due to an ear infection? I am in the waiting process to start the UPT pipeline for the ANG. Last week my left ear felt clogged for about 5 days and I had hearing loss due to this. I did not have a stuffy nose, sore throat, fever or anything like that. Around the 5th day of my ear feeling clogged I got a really bad case of vertigo with nausea and vomiting that lasted a few hours. I went to an immediate care facility where they prescribed Meclizine and said it is probably a viral infection of the ear. They said most likely it is viral Labyrinthitis AKA Vestibular neuronitis. The vertigo only happened once, and I am still dealing with the ear issue though it is not as bad. I am supposed to see an ENT Doctor later this week. I looked this up in the waiver guide and found this:

(From pg 982 & 983 of the waiver guide)

"Vertigo of any etiology is disqualifying for all classes of flying, RPA duties, ATC/GBC duties, and for SMOD personnel.

Vestibular neuronitis is the only major form of peripheral vertigo to have a minimal risk of recurrence, and is the only form of peripheral vertigo for which FC I and unrestricted FC II waivers may be recommended. To be considered for waiver, all symptoms must have resolved, however, with sufficiently normal remaining vestibular function as to cause no clinical disability."

I have yet to start my security clearance. I have already gone through MEPS, but not my FC1 so I'm guessing I have at least about 3-4 months before I start AMS. Does anyone know if it is difficult to get this waiver and what length of time is considered sufficient to deem that all symptoms have resolved?

Edited May 3, 2012 by shift

[Guest]

...Does anyone know if it is difficult to get this waiver and what length of time is considered sufficient to deem that all symptoms have resolved?

I imagine it is all determined by the specialists that you'll see. When you say you no longer have symptoms, assuming it resolves with your infection, the ENT will eval and say yes or no. You will also possibly need an eval from neuro and possibly audiology. All in all, I'd say your waiver chances are looking really good. keep reading the waiver guide section on vertiginous disorders for more info (see link in my signature block for most up to date version).

[flyjetz]

Has anyone dealt with vertigo due to an ear infection? I am in the waiting process to start the UPT pipeline for the ANG. Last week my left ear felt clogged for about 5 days and I had hearing loss due to this. I did not have a stuffy nose, sore throat, fever or anything like that. Around the 5th day of my ear feeling clogged I got a really bad case of vertigo with nausea and vomiting that lasted a few hours. I went to an immediate care facility where they prescribed Meclizine and said it is probably a viral infection of the ear. They said most likely it is viral Labyrinthitis AKA Vestibular neuronitis. The vertigo only happened once, and I am still dealing with the ear issue though it is not as bad. I am supposed to see an ENT Doctor later this week. I looked this up in the waiver guide and found this:

(From pg 582 & 583 of the waiver guide)

"Vertigo of any etiology is disqualifying for all classes of flying, RPA duties, ATC/GBC duties, and for SMOD personnel.

Vestibular neuronitis is the only major form of peripheral vertigo to have a minimal risk of recurrence, and is the only form of peripheral vertigo for which FC I and unrestricted FC II waivers may be recommended. To be considered for waiver, all symptoms must have resolved, however, with sufficiently normal remaining vestibular function as to cause no clinical disability."

I have yet to start my security clearance. I have already gone through MEPS, but not my FC1 so I'm guessing I have at least about 3-4 months before I start AMS. Does anyone know if it is difficult to get this waiver and what length of time is considered sufficient to deem that all symptoms have resolved?

Do some research on Meniere's Disease or Meniere's Syndrome. The four classic symptoms are tinnitus, hearing loss, feeling of pressure or fullness in the ear and occasional vertigo episodes. After 13 years of flying for the AF, I started to have similar issues with my left ear. Over a ten month period, I had 7 vertigo attacks with nausea, vomiting, and diarrhea that would last from 2-4 hours. It was horrendous. I was DNIF'd and run through a battery of balance tests and MRIs. Visiting an ENT is a good first step, but I highly recommend that you insist on seeing a NeurOTOlogist (not a neurologist). They specialize in inner ear issues. I was placed on a diuretic (Maxzide), and all the symptoms went away except for the tinnitus and slight hearing loss. The AF then made me show 12 months of symptom-free history before I was returned to fly. Bottom line, this is a serious issue that you CANNOT afford to fly with, and if you fly with a crew, you would be endangering other people. However, try hard to keep the words "Meniere's Disease" off your medical records. Find a flight surgeon, and a neurotologist that will treat you for MD, but are willing to stay vague in your medical report with terms like "vertiginous episodes". Believe me, this road sucks, but you need to get help for this.

[shift]

Flyjetz,

I saw an ENT and took an audio test in the same day. I have some hearing loss and was prescribed prednisone for 2 weeks. The thought being that it is a viral infection with swelling around the nerve. I did not experience any more vertigo. Well it's been two weeks of prednisone and I still have hearing loss. He wants to inject prednisone directly into my ear. Do you know if the Air Force considers this as a perforated ear drum? He explained that the needle used is so tiny that the ear drum will heal in a day or two. I am worried they will consider this as a perforated ear drum and the 120 waiting period associated with it.

[flyjetz]

Flyjetz,

I saw an ENT and took an audio test in the same day. I have some hearing loss and was prescribed prednisone for 2 weeks. The thought being that it is a viral infection with swelling around the nerve. I did not experience any more vertigo. Well it's been two weeks of prednisone and I still have hearing loss. He wants to inject prednisone directly into my ear. Do you know if the Air Force considers this as a perforated ear drum? He explained that the needle used is so tiny that the ear drum will heal in a day or two. I am worried they will consider this as a perforated ear drum and the 120 waiting period associated with it.

I'm not sure whether or not it would be considered a perforated ear drum. You'd have to ask your flight surgeon. My guess is that they would consider it as such. I'm going to repeat my previous advice. I STRONGLY suggest you demand to be referred to a neurotologist. ENT's have a limited "bag of tricks" when it comes to ear issues. When I first saw the ENT, he prescribed dramamine, for motion sickness. When that didn't work, he wanted to go straight to surgery, by inserting a "silverstein wick" in my ear, and dropping steroids into my ear every few weeks. I was not too keen on this approach, and did some research, which led me to the discovery of the neurotology field. Most of these doctors started out as ENTs, then went on for advanced training dealing exclusively with inner ear disorders. My neurotologist put me on diuretics, and the problem was solved. About two weeks before my PHE, he will prescribe prednisone, which helps reduce the hearing loss temporarily. If you tell me where you are based, I can do some research on the meniere's forums to find you a doctor.

[Guest]

I would say that you most likely will NOT be DNIF'd, or at least not for a prolonged time, as a result of the procedure, but that you might be as a result of the medication. Depending on how long you take Prednisone, and having it directly applied to your middle ear. May cause a number of side effects the doc's wouldn't be comfortable with. I didn't see Prednisone in the "Official Air Force Aerospace Medicine Approved Medications (6 Feb 2012)," so it's tough to say what the recommendation would be. Do a telephone consult with the Doc/Nurse first, and see what they say specifically related to the med.

Back to the procedure though, I don't think it counts under AFI 48-123 which states: 6.44.3.2.4. Surgical repair of perforated tympanic membrane within the last 120 calendar days.

You aren't getting surgery to repair a perforation.

The waiver guide only mentions perforated TM's in relation to "Cholesteatomas" and "Eustachian Tube Dysfunction and Otitis Media," and the Otitis Media (ear infection) is your real primary concern. Verify with the ENT that you should be able to safely Valsalva within a few days of the procedure, and you should be good to go.

I believe you might need to worry about waiver for your Otitis Media. Read the sections on page 334 and 976 of linked waiver guide in my signature (pg #'s for April 2012 version).

[Tnkrdriver]

Over the last few months have had a feeling of fullness and a small bit of hearing loss in my right ear. Additionally, when I swallow you can hear popping in the ear sort of like it is equalizing. After three appointments at the flight doc (claritin, sudafed, nasal rinse didnt work) they finally sent me to an ent. The ent tried to scope my sinuses but said that it was way to tight to even get into the right side and my Eustachian tube was blocked. He prescribed me a steroid and antibitocis after another two weeks that did not work so on the next visit he perforated my ear drum and gave me some nasonex. It has been two days and still no improvement. I am looking for any advice to try and clear this problem....

[Guest]

The advice you want is too specific to your situation for an internet forum. Call/see your ENT/Flight Surgeon and update him on your symptoms and progression of your illness.

[Motrin]

The advice you want is too specific to your situation for an internet forum. Call/see your ENT/Flight Surgeon and update him on your symptoms and progression of your illness.

+1

[Tnkrdriver]

So apparently this procedure is still (relatively) new, but has anyone heard of eustachian tuboplasty? It's for Eustachian Tube Dysfunction (ETD) and helps to clear out the eustachian tube to be able to equalize the ear better.

Does the Air Force have anything on this, whether it's a DQ or not for FC I, II, or III?

Thanks

So did you get the procedure done? and if so were you able to take your FC1?