During climbs and descents, the free gas formerly present in various body cavities expands due to a difference between the pressure of the air outside the body and that of the air inside the body. If the escape of the expanded gas is impeded, pressure builds up within the cavity and pain is experienced. Trapped gas expansion accounts for ear pain and sinus pain, as well as a temporary reduction in the ability to hear.

The middle ear is a small cavity located in the bone of the skull. It is closed off from the external ear canal by the eardrum. Normally, pressure differences between the middle ear and the outside world are equalized by a tube leading from inside each ear to the back of the throat on each side called the Eustachian tube. These tubes are usually closed but open during chewing, yawning, or swallowing to equalize pressure. Even a slight difference between external pressure and middle ear pressure can cause discomfort. [Figure 17-2]

[Figure 17-2]

During a climb, middle ear air pressure may exceed the pressure of the air in the external ear canal causing the eardrum to bulge outward. Pilots become aware of this pressure change when they experience alternate sensations of “fullness” and “clearing.” During descent, the reverse happens. While the pressure of the air in the external ear canal increases, the middle ear cavity, which equalized with the lower pressure at altitude, is at lower pressure than the external ear canal. This results in the higher outside pressure causing the eardrum to bulge inward.

This condition can be more difficult to relieve due to the fact that the partial vacuum tends to constrict the walls of the Eustachian tube. To remedy this often painful condition, which also causes a temporary reduction in hearing sensitivity, pinch the nostrils shut, close the mouth and lips, and blow slowly and gently into the mouth and nose.

This procedure forces air through the Eustachian tube into the middle ear. It may not be possible to equalize the pressure in the ears if a pilot has a cold, an ear infection, or sore throat. A flight in this condition can be extremely painful, as well as damaging to the eardrums. If experiencing minor congestion, nose drops or nasal sprays may reduce the risk of a painful ear blockage. Before using any medication, check with an AME to ensure that it will not affect the ability to fly.

In a similar way, air pressure in the sinuses equalizes with the pressure in the flight deck through small openings that connect the sinuses to the nasal passages. An upper respiratory infection, such as a cold or sinusitis, or a nasal allergic condition can produce enough congestion around an opening to slow equalization. As the difference in pressure between the sinuses and the flight deck increases, congestion may plug the opening. This “sinus block” occurs most frequently during descent. Slow descent rates can reduce the associated pain. A sinus block can occur in the frontal sinuses, located above each eyebrow, or in the maxillary sinuses, located in each upper cheek. It usually produces excruciating pain over the sinus area. A maxillary sinus block can also make the upper teeth ache. Bloody mucus may discharge from the nasal passages.

Sinus block can be avoided by not flying with an upper respiratory infection or nasal allergic condition. Adequate protection is usually not provided by decongestant sprays or drops to reduce congestion around the sinus openings. Oral decongestants have side effects that can impair pilot performance. If a sinus block does not clear shortly after landing, a physician should be consulted.

Spatial Disorientation and Illusions

Spatial disorientation specifically refers to the lack of orientation with regard to the position, attitude, or movement of the airplane in space. The body uses three integrated systems that work together to ascertain orientation and movement in space.

• Vestibular system—organs found in the inner ear that sense position by the way we are balanced

• Somatosensory system—nerves in the skin, muscles, and joints that, along with hearing, sense position based on gravity, feeling, and sound

• Visual system—eyes, which sense position based on what is seen

All this information comes together in the brain and, most of the time, the three streams of information agree, giving a clear idea of where and how the body is moving. Flying can sometimes cause these systems to supply conflicting information to the brain, which can lead to disorientation. During flight in visual meteorological conditions (VMC), the eyes are the major orientation source and usually prevail over false sensations from other sensory systems. When these visual cues are removed, as they are in instrument meteorological conditions (IMC), false sensations can cause a pilot to quickly become disoriented.

The vestibular system in the inner ear allows the pilot to sense movement and determine orientation in the surrounding environment. In both the left and right inner ear, three semicircular canals are positioned at approximate right angles to each other. [Figure 17-3] Each canal is filled with fluid and has a section full of fine hairs. Acceleration of the inner ear in any direction causes the tiny hairs to deflect, which in turn stimulates nerve impulses, sending messages to the brain. The vestibular nerve transmits the impulses from the utricle, saccule, and semicircular canals to the brain to interpret motion.

[Figure 17-3]

The somatosensory system sends signals from the skin, joints, and muscles to the brain that are interpreted in relation to the Earth’s gravitational pull. These signals determine posture. Inputs from each movement update the body’s position to the brain on a constant basis. “Seat of the pants” flying is largely dependent upon these signals. Used in conjunction with visual and vestibular clues, these sensations can be fairly reliable. However, the body cannot distinguish between acceleration forces due to gravity and those resulting from maneuvering the aircraft, which can lead to sensory illusions and false impressions of an aircraft’s orientation and movement.

Under normal flight conditions, when there is a visual reference to the horizon and ground, the sensory system in the inner ear helps to identify the pitch, roll, and yaw movements of the aircraft. When visual contact with the horizon is lost, the vestibular system becomes unreliable. Without visual references outside the aircraft, there are many situations in which combinations of normal motions and forces create convincing illusions that are difficult to overcome.

Prevention is usually the best remedy for spatial disorientation. Unless a pilot has many hours of training in instrument flight, flight should be avoided in reduced visibility or at night when the horizon is not visible. A pilot can reduce susceptibility to disorienting illusions through training and awareness and learning to rely totally on flight instruments.

Next

Return to Human Factors

Back

Become a Pilot

Still Growing

This website is in the very early stages of development at the moment. While I'm currently working on pulling information from the Pilot’s Handbook of Aeronautical Knowledge my next goal will be to process information from all the documents referenced in the private pilot’s Airman Certification Standards. So, please come back as I'll regularly be providing you with more and more information.