Ear Problems When You Fly? It May Be More Than Just An Annoyance

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Even if you're only an occasional flyer, you're probably familiar with the ear popping and sinus pressure that often occurs as your airplane makes its descent to land. Often called airplane ear, the condition typically produces only mild discomfort that disappears upon landing. However, in some cases, it can result in a condition called barotrauma, which can produce severe ear and sinus pain, nosebleeds, and even mild to severe hearing loss. There are precautions you can take to reduce the likelihood of experiencing barotrauma, as well as techniques you should use if you do experience it.

The Ear, Nose and Sinus Connection

To better understand the cause of airplane ear and barotrauma, you first need a short lesson in anatomy. The ear is divided into 3 sections: the outer ear or the part you can see; the middle ear, which is separated from the outer ear by the ear drum; and the inner ear, which is located in the skull behind the outer ear, and along with the ear drum, plays a large part in hearing.

The Eustachian tube connects the middle ear to the back of the throat and nasal cavity. It equalizes the air pressure between the middle ear and the outside air pressure. It also helps drain mucous from the middle ear into the nose and throat.

The sinuses are 4 pairs of cavities on either side of the nose that help to clean the air you breathe. Like the nose, the sinuses are filled with mucous. They are also prone to infection, causing them to fill with pus and mucous, which can cause a runny nose and sinus pain.

The Airplane and Ear Connection

Although modern aircraft are pressurized, there are still some pressure fluctuations while ascending and descending. The Eustachian tube attempts to equalize the pressure in the middle ear with the pressure in the airplane. However, if the Eustachian tube is blocked, such as with mucous or pus from a sinus or upper respiratory infection, it can't equalize the pressure, which can cause trauma to the inner ear and ear drum. This is called barotrauma.

Symptoms, Diagnosis and Treatment

Symptoms of barotrauma can range from mild to severe. They include clogged ears, headaches, ear pain, nose bleeds, bleeding from the ears, dizziness, hearing loss and tinnitus or ringing in the ears. In mild cases, the symptoms disappear soon after landing. It often helps to yawn, chew gum or suck on candy. You can also try over-the-counter decongestants and nasal sprays.

If symptoms don't improve in a day, you should consider it a medical emergency and call your physician or ear, nose and throat specialist. If left untreated, barotrauma can cause permanent hearing loss. He or she will get your medical history and check your ears to determine any damage. Often they can diagnose barotrauma by a bulging ear drum caused by the pressure difference.

Depending on severity, your doctor may prescribe pain killers, antihistamines in cases of allergies, decongestants, steroids, and antibiotics for any upper respiratory infections or sinusitis. In rare cases, your doctor may perform surgery to cut a small slit in the ear drum to equalize the pressure between the middle and outer ear. In severe cases, he or she may surgically place tubes in the middle ear to keep the pressure stabilized.


If you have bad allergies, a sinus infection or upper respiratory infection, most doctors recommend not flying, as you are much more likely to have a barotrauma incident. However, if flying can't be postponed, there are a few preventative measures you can take.

  • Take decongestants or antihistamines an hour before landing.
  • Avoid alcoholic beverages in flight as alcohol causes the Eustachian tube to swell. 
  • Use ear plugs specially designed to prevent barotrauma. You can find them at most airports.
  • Don't sleep while landing. Instead, chew gum and yawn frequently.

For more information, contact Cohen Angelique MD SC or a similar medical professional.