Are ear infections more likely when visiting high altitudes?

Question

We recently took our toddler to the Alps, and I was surprised when multiple people asked me if I was worried about her getting an ear infection due to the high altitude (the highest point was 2770 m). We checked with her pediatrician last year before visiting high altitudes when she was 7 months old, and he made no mention of possible ear infections due to altitude (slow acclimatization to prevent altitude sickness and lots of sunscreen, yes, but no other concerns).

In the end, she got an ear infection during our trip. Was it a coincidence? Is increased likelihood of an ear infection when visiting high altitude an old wives tale or is there some truth to it?

Answer 1

It is true that high altitudes can cause an increased risk of ear infection. JohnP mentioned in his comment that on the National Institutes of Health (NIH) website for acute ear infections, it says that "Changes in altitude or climate" can increase the risk of getting an ear infection. The reason for this is also explained on the NIH website. That page describes very succinctly what happens to your ears when you experience changes changes altitude (ie: going up a mountain, flying in a plane).

The air pressure outside of your body changes as altitude changes. This creates a difference in pressure on the two sides of the eardrum.

This difference in pressure can block your Eustachian tube, the tube that connects the back of your nose and upper throat to your middle ear, which can cause an ear infection. A blockage in the Eustachian tube can also lead to something known as ear barotrauma, which is just discomfort in the ear, not a full ear infection, but may look and feel similar to one if it is severe enough. It should also be noted that young children are at a much higher risk for their Eustachian tube to be blocked, which may also be a contributing factor to why your daughter got an ear infection.

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^{NIH: Ear infection - acute}

^{NIH: Ear - block at high altitudes}

^{NIH: Ear barotrauma}

^{WebMD: Blocked Eustachian Tubes}

^{Healtline: Ear Barotrauma}

Answer 2

Eustachian tube which connects the ear and throat can get blocked and the pressure difference during the altitude change can give rise to pain. If there is infection in the throat it can produce infection in the ear through the ET. Altitude is not the cause of ear infection. ET has to open for the pressure on both sides of the ear drum to become equal and the pain and blockage in the ear will be reduced.