Ear Clearing - Methods

Methods

The ears can be cleared by various methods, some of which pose a distinct risk of barotrauma including perforation of the eardrum:

• Yawning which helps to open the eustachian tubes;
• Swallowing which helps to open the eustachian tubes;
• The "Frenzel maneuver": using the rear part of the tongue and throat muscles;. Another description of the method is to close the nostrils, and close the back of the throat as if straining to lift a weight. Then make the sound of the letter "K." This pushes the back of the tongue upward, compressing air into the openings of the eustachian tubes.
• "Politzerization": a medical procedure that involves inflating the middle ear by blowing air up the nose during the act of swallowing;
• The "Toynbee maneuver": pinching the nose and swallowing. Swallowing pulls open the eustachian tubes while the movement of the tongue, with the nose closed, compresses air which passes through the tubes to the middle ear.
• The "Valsalva maneuver": pinching the nose and closing the mouth and trying to breathe out through the nose. If the hand cannot reach the nose, it is possible to learn to pinch the nose shut by the action of two small face muscles called compressor naris. This is the first technique normally taught, but needs to be performed gently to lessen side-effects.
• The "Lowry Technique". A combination of Valsalva and Toynbee: pinching the nose to close the nostrils, and blow and swallow at the same time.
• The "Edmonds Technique". While tensing the soft palate (the soft tissue at the back of the roof of the mouth) and throat muscles and pushing the jaw forward and down, do a Valsalva maneuver.
• Voluntary opening of the eustachian tubes: Voluntary opening of the tubes: Voluntary Tubal Opening:(French: béance tubaire volontaire (BTV) ) is a method of equalising or clearing the ears described by doctor Georges Delonca and used in scuba diving and freediving. It aims to rebalance the pressure between the external ear and middle ear. The subject must either exercise a voluntary control of the tensor veli palatini muscles opening the eustachian tubes, or move the jaw to open the tubes when necessary. This is less easy to execute than the Valsalva maneuver, but the BTV is the gentlest method to clear the ears. However, not all divers can perform this manoeuvre. It may be necessary to engage in ear training exercises to train the muscles to perform this manoeuvre. Another description of the method is to tense the muscles of the soft palate and the throat while pushing the jaw forward and down as if starting to yawn. This should pull the eustachian tubes open.
• Some people learn to voluntarily 'click' their ears, together or separately, which is a noise emitted and its sound heard internally, when deliberating doing a pressure equalizing routine by opening their Eustachian tubes, where pressure changes are experienced (as in ascending/descending in aircraft flight, mountain driving, elevator lift/drops, etc.), whether anticipated or unexpected. Some even are able to deliberately keep their Eustachian tubes open for a brief period, and even increase or decrease air pressure in the middle ear. The 'clicking your ears' can actually be heard audibly if one puts one's ear to another person's ear for them to hear the clicking sound. Those that are borderline on learning this voluntary control first discover this via yawning or swallowing or other means (above); which later on discover can be done deliberately without force even when there are no pressure issues involved, by 'clicking one's ears' (Can you 'click your ears' to equalize air pressure in your inner ear?). When the Eustachian Tubes are deliberately held open voluntarily, one's voice sounds louder in one's head than when they are closed.

No single method is considered safest or most successful in equalization of the middle ear pressure. Using alternative techniques may improve the success individually when a technique fails.