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Hearing Loss, Noise-InducedFLIGHT-EARNCT07200310

Hearing/ET/Vestibular in Balloon Pilots

An observational study of Hearing Loss, Noise-Induced and Eustachian Tube Dysfunction, run by Gaziosmanpasa Research and Education Hospital at 2 sites in Turkey (Türkiye).

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

This study looks at whether working as a hot-air balloon pilot-being exposed to burner noise, changes in air pressure/temperature, and vertical acceleration-is linked to changes in hearing, Eustachian tube function, and vestibular (balance) function. Read more about this study

Who is it for?
Ages 18 years and olderHealthy volunteers can take part
What is being tested?
Non-invasive audiologic and vestibular assessments
How many people
105 participants
Where
2 sitesTurkey (Türkiye)
Study dates
4 Sep 2025to 30 Nov 2025
Phase
Observational
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Study population: Adults (≥18 years) in two cohorts: (1)(Hot-Air Balloon Pilots) licensed hot-air balloon pilots operating in the Cappadocia/Nevşehir region with ≥10 flights in the prior 12 months; and (2)(Controls) age-matched adults with no occupational or recreational exposure to significant noise, altitude, or barometric pressure variation (e.g., non-pilots, non-divers, non-cabin crew). Participants are healthy volunteers with otoscopic suitability (no perforation or active infection). Recruitment is via local pilot companies/registries and the surrounding community; all assessments occur at the SBÜ Gaziosmanpaşa Training and Research Hospital ENT/audiology laboratory (single-center). Planned enrollment: 45 pilots and 45 controls.

Who may be able to join

  • Age ≥18 years (preferably 18-70).
  • Pilot group: Licensed, professional and actively flying hot-air balloon pilots with regular flight over the past 12 months (on average 5 days per week and at least 20 flights in month), not using any hearing-protection equipment, and typically each flying et least 60-90 minutes.
  • Control group: Adults without occupational or recreational exposure to significant pressure/altitude/noise (e.g., no mountaineering, scuba diving, or cabin crew duties).
  • Otoscopic suitability for testing (no tympanic membrane perforation; no active ear infection).

Who cannot join

  • Acute upper respiratory tract infection (URTI) or otitis at the time of testing.,
  • High noise exposure within the past 24-48 hours (e.g., concert, workshop).
  • Tympanic membrane perforation; impacted cerumen that cannot be cleared; chronic suppurative otitis; presence of an active ventilation (tympanostomy) tube.
  • History of otologic surgery.
  • Menière's disease; significant otosclerosis; vestibular neuritis within the past 6 months; recent sudden hearing loss.
  • Significant neurological disease or history affecting balance (e.g., multiple sclerosis, stroke).
  • Use of ototoxic medications within the past 3 months (e.g., aminoglycosides, cisplatin).
  • Contraindications to cVEMP testing (e.g., significant cervical pathology or prior cervical surgery, uncontrolled hypertension, suspected advanced carotid artery disease).

Trial locations and contacts

2 sites in 1 country.

Turkey (Türkiye)2 sites
  • University of Health Sciences, Gaziosmanpaşa Training and Research Hospital, Department of Otorhinolaryngology-Head & Neck Surgery (ENT/Audiology Laboratory)

    Istanbul, 34108

  • Cappadocia Field Site (Göreme) - On-site assessments at hot-air balloon pilot companies

    Nevşehir, Göreme, 50200

Other trials in Turkey (Türkiye)

About this study

Official title: Hearing and Eustachian/Vestibular Functions in Hot Air Balloon Pilots: A Cross-sectional Matched-Control Study

This study looks at whether working as a hot-air balloon pilot-being exposed to burner noise, changes in air pressure/temperature, and vertical acceleration-is linked to changes in hearing, Eustachian tube function, and vestibular (balance) function. Adult pilots from Cappadocia will be compared with adults who do not have these exposures.

Approximately 90 participants are expected to be enrolled For contextual exposure information, representative in-field noise measurements during balloon operations and basic flight parameters may be documented

Read more

Each participant will attend one visit (~60 minutes) in an ENT/audiology laboratory. After a short questionnaire and an ear exam (otoscopy), the following non-invasive tests will be performed: tympanometry; tympanometry with simple maneuvers (Valsalva/Toynbee) to evaluate Eustachian tube function (ΔTPP); pure-tone audiometry (including extended high frequencies); otoacoustic emission tests (TEOAE and DPOAE); acoustic (stapedius) reflex thresholds; and a brief cervical vestibular evoked myogenic potential (cVEMP) test. Symptom-triggered questionnaires will also be used: for participants reporting tinnitus, the Tinnitus Handicap Inventory (THI); for those reporting dizziness, the Berg Balance Scale (BBS).

No medications or blood tests are involved. Testing is safe and routinely used in clinical care. Risks are minimal (for example, temporary ear-canal pressure or brief dizziness). Testing will be stopped if any discomfort occurs. Personal information will be kept confidential, and results will be reported only in group form. Findings from this study may help improve occupational health guidance for hot-air balloon pilots.

Read the detailed description

This study looks at whether working as a hot-air balloon pilot-being exposed to burner noise, changes in air pressure/temperature, and vertical acceleration-is linked to changes in hearing, Eustachian tube function, and vestibular (balance) function. Adult pilots from Cappadocia will be compared with adults who do not have these exposures.

Approximately 90 participants are expected to be enrolled For contextual exposure information, representative in-field noise measurements during balloon operations and basic flight parameters may be documented

Each participant will attend one visit (~60 minutes) in an ENT/audiology laboratory. This is a cross-sectional study with a single assessment visit. The following non-invasive tests will be performed

Tympanometry.

Acoustic (stapedius) reflex thresholds.

Tympanometry with simple maneuvers (Valsalva/Toynbee) to evaluate Eustachian tube function (pressure change in the middle ear) (ΔTPP).

Pure-tone audiometry (standard clinical frequencies and extended high frequencies).

Otoacoustic emission tests (OAE), including transient-evoked (TEOAE) and distortion-product (DPOAE), with analysis including high frequencies.

Cervical vestibular evoked myogenic potential (cVEMP) (a test of inner-ear balance reflexes), administered for all participants using a standardized protocol and EMG monitoring for adequate sternocleidomastoid activation.

Symptom-triggered questionnaires:

For participants reporting tinnitus, the Tinnitus Handicap Inventory (THI) will be administered.

For participants reporting dizziness, the Berg Balance Scale (BBS) will be administered.

Testing is non-invasive and performed in a sound-treated environment per routine clinical practice. If any discomfort (e.g., significant dizziness, pain, or elevated blood pressure) occurs, the relevant test is stopped and the participant may be withdrawn from testing at the investigator's discretion. For contextual exposure information, representative in-field noise measurements, air-pressure and altitude during balloon operations and basic flight parameters may be documented where available; these are not required for participation.

Data are recorded under coded study IDs and stored on secure institutional servers with access restricted to authorized study staff. Results will be reported in aggregate to protect confidentiality.

Being tested
Non-invasive audiologic and vestibular assessments
Keywords
Hot-Air Balloon Pilots, Noise Exposure, Hearing Loss, Eustachian Tube Function, Vestibular Function, cVEMP, Otoacoustic Emissions (OAE), Acoustic Reflex, Occupational Health, Altitude / Barometric Pressure
Medical subject headings
Hearing Loss, Noise-Induced, Hearing Loss

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Non-invasive audiologic and vestibular assessmentsOther

    Also called Audiologic and vestibular test battery, Hearing and balance function tests, Audiologic evaluations, Vestibular assessments

    standardized, single-session test battery performed in a sound-treated clinical laboratory. Procedures include tympanometry, tympanometry with simple maneuvers (Valsalva/Toynbee) for Eustachian tube function, pure-tone audiometry, otoacoustic emission (OAE) testing, acoustic reflex thresholds, and cervical vestibular evoked myogenic potentials (cVEMP) with EMG monitoring for adequate sternocleidomastoid activation. Testing is non-invasive, takes ~60 minutes, and is conducted under routine clinical practice conditions. No investigational drugs, devices, or biospecimens are used.

Study groups in NCT07200310
Study groupRoleWhat they receive
Hot-Air Balloon PilotsLicensed, professional and actively flying hot-air balloon pilots (≥18 years) with regular flight over the past 12 months (on average 5 days per week and at least 20 flights in month), not using any hearing-protection equipment, and typically each flying et least 60-90 minutes. Participants undergo a single non-invasive laboratory session including, tympanometry, tympanometry with maneuvers (Valsalva/Toynbee) for Eustachian tube function, pure-tone audiometry, otoacoustic emission (OAE) testing, acoustic reflex thresholds, and cervical vestibular evoked myogenic potential (cVEMP). No drugs, devices, or biospecimens are used.
Receives: Other: Non-invasive audiologic and vestibular assessments
Control GroupAge (≥18 years) without occupational or recreational exposure to noise, altitude, or barometric pressure changes. Participants undergo the same single non-invasive laboratory session as the pilot group (tympanometry, pure-tone audiometry, OAE tests, acoustic reflex thresholds, and cVEMP). No drugs, devices, or biospecimens are used.
Receives: Other: Non-invasive audiologic and vestibular assessments

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Eustachian Tube Function (ΔTPP after Valsalva/Toynbee)

    Tympanometric middle-ear pressure change (ΔTPP in daPa) after maneuvers will be recorded. Impaired function defined as ΔTPP ≤15 daPa.

    Measured: At baseline, single visit (~5 minutes)

  2. Distortion Product Otoacoustic Emission (DPOAE) amplitudes at 1-12 kHz

    Mean DPOAE amplitudes at 1-12 kHz will be compared between hot-air balloon pilots and controls. Lower amplitudes are hypothesized in pilots with greater flight exposure.

    Measured: At baseline, single visit (~5 minutes)

  3. Transient-Evoked Otoacoustic Emission (TEOAE)

    Description: Mean TEOAE SNRs (dB) in half-octave bands from 1-4 kHz (and overall response/reproducibility %) will be compared between hot-air balloon pilots and controls. Lower SNRs are hypothesized in pilots with greater flight exposure.

    Measured: At baseline, single visit (~5 minutes)

Secondary outcomes (7)
  1. Tympanometry middle-ear pressure (TPP) and compliance

    Description: Tympanometric peak pressure (TPP, daPa) and middle-ear compliance (ml) values will be obtained and compared between hot-air balloon pilots and controls. Abnormal or more negative TPP values are hypothesized in pilots with greater flight exposure, indicating possible Eustachian tube dysfunction.

    Measured: At baseline, single visit (~3 minutes)

  2. Pure-Tone Audiometry thresholds

    Air-conduction thresholds at standard clinical frequencies and high frequencies. Hypothesis: higher thresholds in pilots.

    Measured: At baseline, single visit

  3. Cervical Vestibular Evoked Myogenic Potential (cVEMP) parameters

    cVEMP amplitude and latency measured bilaterally. Hypothesis: altered responses in pilots.

    Measured: At baseline, single visit

  4. Acoustic Reflex Thresholds

    Lowest sound level (dB HL) eliciting stapedius reflex, when measurable.

    Measured: At baseline, single visit

  5. In-field noise metrics during balloon operation (exploratory)

    LAeq, LAFmax, and LCpeak recorded for contextual analysis. During flight observations (subset only)

    Measured: During balloon flight, single observation (~60-90 minutes)

  6. Tinnitus Handicap Inventory (THI) score

    Self-reported tinnitus-related handicap, total score (0-100).

    Measured: Baseline, single visit

  7. Berg Balance Scale (BBS) score

    Self-reported balance function, 14-item scale (0-56).

    Measured: Baseline, single visit

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted1 Oct 2025
  2. Study start4 Sep 2025
  3. Primary completion20 Oct 2025
  4. Study completion30 Nov 2025

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Observational
Observational model
Case-control
Time perspective
Cross-sectional
Enrolment
105 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT07200310
Sponsor's protocol ID
Cappadoc-baloon-odio
Acronym
FLIGHT-EAR
Status last verified
Aug 2025
First submitted
13 Sep 2025
Last updated
21 Jan 2026
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
No: No plan to share individual participant data (IPD). The informed consent and protocol do not authorize IPD sharing, and the cohort is small and identifiable (hot-air balloon pilots in a defined region), increasing re-identification risk. Per protocol, only aggregate, de-identified results will be reported; source data remain on secure institutional servers accessible only to the study team.

Publications

  • Avci D, Sahin MI. Are the hearing and eustachian tube functions of the hot air balloon pilots disturbed? Auris Nasus Larynx. 2022 Aug;49(4):577-583. doi: 10.1016/j.anl.2021.11.002. Epub 2021 Nov 25.

    PubMed 34840034
  • Sahin Ceylan D, Sacli Y, Gultekin G, Avsar B, Ozver AG. Do Flights Affect Hearing in Hot Air Balloon Pilots? Am J Audiol. 2023 Nov 22:1-10. doi: 10.1044/2023_AJA-23-00126. Online ahead of print.

    PubMed 37992408

Questions about this trial

What is this clinical trial studying?

An observational study of Hearing Loss, Noise-Induced and Eustachian Tube Dysfunction, run by Gaziosmanpasa Research and Education Hospital at 2 sites in Turkey (Türkiye).

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 4 inclusion and 8 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 21 Jan 2026. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 2 sites in Turkey (Türkiye). Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Eustachian Tube Function (ΔTPP after Valsalva/Toynbee) (time frame: At baseline, single visit (~5 minutes)). The study lists 3 primary outcomes in all. It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT07200310, which also lists 2 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 21 Jan 2026.

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