The tympanic membrane transmits vibrations of air to the middle ear.
This flexible membrane is sensitive to external pressure changes.
While a decrease in ambient pressure is usually well tolerated,
an increase in ambient pressure can cause discomfort and sometimes excruciating pain.
Ear ventilation disorders can cause discomfort while descending in an aircraft, especially if you have a cold, which already hampers the ventilation of the middle ear.
During descent in an aircraft the cabin pressure increases, which blocks the Eustachian tube.
It then becomes almost impossible for the pressure to equalize in a normal manner.
In many cases decongestants are not successful, because the negative pressure in the middle ear is not relieved in spite of the reduction
Furthermore, the use of decongestants can dry out the mucous membrane.
Exercising the so-called Valsalva-maneuver (i.e.: pinchig the nostrils and closing the mouth while exhaling) is mostly fruitless,
because the Eustachian tube will blocked more solidly by the increased tissue- and vein-pressure. In addition, the Valsalva-maneuver can result in abrupt and damaging pressure equalization of the middle ear. The Valsalva-maneuver should, therefore, be considered obsolete.
Tube function disorders could also appear after diving, during trips in the mountains and anywhere else, where height and altitude differences need to be managed.
Although tube function disorders are usually related to the middle ear, it is known that inner ear diseases could be a result of reduced pressure equalization as well.
Ventilation disorders of the middle ear can also lead to middle ear fluid.
Middle ear fluid is often observed in children, since children are more susceptible to tube function disorders than adults.
(Recurrent collection of fluid in the middle ear may result not only in middle ear deafness, but may also lead to impaired speech development. If conservative treatment, e.g. decongestants and antibiotics are not effective, a ventilation tube is typically inserted.)