Ear — 16 June 2014
Do Your Ears Hurt when Flying?

Many people who don’t normally fly are taking trips for summer vacation during the next few months. For some, an trip via air translates to uncomfortable ear pain. It varies from person to person but usually is most noticeable when the plane descends to land. The pain is worse the lower the aircraft descends in elevation and can be quite acute on landing.

The pain is caused by unequal pressure that develops between the air that is trapped in the middle ear and the air outside the ear. This air space is connected to the back of the nose by a tiny channel called the Eustachian tube. The air on either side of the eardrum should be at the same pressure. As a plane descends the air pressure becomes as you get ready to hit the tarmac. This pushes the eardrum inwards which can be painful. To relieve this, the pressure inside the middle ear has to rise quickly too. Air needs to travel up the Eustachian tube into the middle ear to equalise the pressure.

The Eustachian tube is normally closed but opens from time to time when we swallow, yawn or chew. In most people, just normal swallowing and chewing quickly cause air to travel up the Eustachian tube to equalize the pressure. Many passengers choose to crew gum or suck on hard candy when taking off or coming in for a landing.

However, the Eustachian tube in some people does not open as easily and so the pressure may not be evened so quickly. Consider that some people may have a narrow Eustachian tube than normal and some have conditions — like a cold, infection or hayfever — that causes a blockage to the Eustachian tube. For those passengers, the air can’t travel up the tube quickly enough. Ideally, anyone with a cold, respiratory infection, or ear infection should not fly. However, not many people will cancel their airplane trips for this reason. but, come on, who wants to let a little cold ruin a week or two of fun at some exotic locale.

Here are some tips to alleviate possible ear pain:

  • Suck on hard candy when the plane begins to descend. Air is more likely to flow up the Eustachian tube if you swallow, yawn or chew. For babies, it is a good idea to feed them or give them a bottle upon descent to encourage them to swallow.
  • Breathing Technique Breathe in deeply and try to breathe out gently with your mouth closed while pinching your nose. This way, no air is blown out your mouth while you are gently pushing air into the Eustachian tube. If you do this you may feel your ears go ‘pop’ as air is pushed into the middle ear. This often cures the problem. Repeat this every few minutes until landing or whenever you feel any discomfort in the ear.
  • Do not sleep when the plane is descending to land. If you are extra-tired, ask the flight attendant to wake you when the plane starts to descend. Alert passengers can make sure to try techniques like the sucking or breathing ideas above, and thereby encourage air to get into the middle ear.

What if you have tried all of those tips and you still get pain in the ear while flying?

  • Antihistamine. Take the recommended dose the day before and the day of travel. This may help to limit the amount of mucus that you make. Mucus often blocks the inner ear tubes.
  • A decongestant nasal spray can dry up the mucus in the nose. Try and find one with xylometazoline, like Otrivin. Spray the nose about one hour before the expected time of descent. Spray again five minutes later. Then spray every 20 minutes until landing.
  • Air pressure regulating ear plugs. These are cheap, reusable ear plugs, such as EarPlanes, that are often sold at airports and in many pharmacies. These ear plugs slow the rate of air pressure change on the eardrum. Basically, you put them in before the door of the aircraft is shut. Some people then wear them for the entire flight. Some people take them out when the plane reaches cruising height, and then place them in again just before the plane starts to descend to land.

If the all of these measures fail, rest assured that the pain normally goes away quickly. If not, you can take over-the-counter pain medicine. Fluid sometimes accumulates in the middle ear for a few days after the flight, which may make hearing rather dull for a while. But if it doesn’t soon subside, please see one of our doctors to get treatment.

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