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Ear Pain and Pressure on Airplanes

Ear issues on flights are very common, whether it is the feeling of pressure build-up in the ear or flying with an ear infection. As an ear specialists we see these issues on a daily basis here at Southern California Head & Neck and can provide some tips on how to deal with them.

But first, here is a quick explanation about why you experience that annoying pain or pressure when ascending or descending from a high altitude. First of all, your eustachian tube is a small tube that connects your middle ear with the back of your nose. When you swallow, yawn or try to “pop your ears” you are basically forcing this tube open so that the pressure equalizes between your middle ear and the outside environment.

On a flight, the changes in altitude when ascending or descending cause changes in the outside pressure. Most people will swallow or yawn to open the Eustachian tube in order to equalize this outside pressure with the pressure in the middle ear. However, especially in people who are sick with a cold or sinus infection or people with allergies, the Eustachian tube may be swollen and not open completely. As a result, negative pressure builds up within the middle ear causing pain, decreased hearing and a clogged sensation. Rarely, the pressure can even cause a perforation in the ear drum.

So what can you do if you are flying with a cold or allergies or if you are just prone to this type of Eustachian tube dysfunction while flying? Here are some things that may help:

  • Chewing gum or sucking on candy during ascent and descent
  • Yawning
  • Avoid sleeping during descent since you may not be swallowing and opening your eustachian tube while you are asleep
  • If yawning and chewing are not effective, pinch your nostrils shut and try to blow out of your nose gently
  • You can take a decongestant pill (ie: sudafed) or a decongestant nasal spray (ie: afrin) about an hour before the flight to help reduce any inflammation around the Eustachian tube. Afrin can also be used again before descent but be sure to limit the use of Afrin as it can cause rebound congestion
  • for babies/children with this issue you can feed them during the flight to force them to swallow

If you have tried all of the above and continue to have issues with your ear after your flight, it is important for you to see us to make sure that your ear drum is not damaged. We can also try to provide more longer term therapies that can help relieve the ear pressure. If the problem persists for several weeks despite our medical therapy we may make a small incision in your ear drum (myringotomy) to relieve the pressure or may even perform a new promising procedure called Eustachian tube dilation.

Call our office today for more information. We look forward to caring for you.

By: Abbas Anwar, MD