Eardrum perforation during air travel is relatively uncommon. It may occur when the eardrum is naturally thin, and the Eustachian tube becomes blocked due to conditions like upper respiratory infections or sinusitis, impairing its function. This leads to an excessive pressure difference between the middle ear and the external environment, potentially causing the eardrum to rupture.As the aircraft ascends to higher altitudes, the external air pressure decreases, causing the pressure in the middle ear to exceed atmospheric pressure. This makes the eardrum bulge outward, resulting in a feeling of fullness and discomfort in the ear.During descent, the pressure in the middle ear becomes lower than atmospheric pressure, causing the eardrum to retract. This creates a pressure difference on both sides of the eardrum, leading to congestion. Passengers may experience ear pain, and in severe cases, the eardrum may rupture.If a rupture occurs, it typically heals on its own. However, it is important to avoid blowing the nose, prevent colds, and keep water out of the ear for at least one month to aid recovery.