Ear problems when flying

Ear problems occur when flying if you are not able to equalize the pressure in your middle ear. If the tube between the nose and the ear, the Eustachian tube, is blocked then the pressure in the middle ear will not be able to adjust as the pressure in the cabin changes.

As the aircraft ascends the pressure in the air outside falls and although pumping air into the cabin pressurizes commercial aircraft, the actual cabin pressure does fall relative to the ground level. The changes in middle ear pressure usually lag behind the pressure changes in the nose and cabin and therefore the middle ear pressure is often relatively higher during ascent and relatively lower during descent. The air in the middle ear is usually able to equalize during ascent as air is pushed down the Eustachian tube. It is therefore unusual to get ear problems during take off and ascent.

As the plane begins to descend and prepares for landing, the pressure in the cabin increases and the air in the middle ear will develop a relative negative pressure to it (like a vacuum) unless the Eustachian tube works properly. It is this that causes pain, hearing loss and if bad, severe problems like permanent deafness, tinnitus and vertigo.

The following advice can help avoid ear problems when flying:

  1. Stay awake for descent and landing.
  2. Drink plenty of fluids and water.
  3. Avoid too much alcohol, tea or coffee as these will dehydrate you and make the ears block up more.
  4. Nasal decongestants (e.g. Sinex or Otrivine) can be helpful. Use 1 hour before landing. Put 2 puffs of spray up each nostril. This can be used twice daily for a maximum of a week but should not be used for longer as it can damage the lining of the nose. Do not use if asthmatic.
  5. Swallow, yawn, suck sweets etc during descent to try to prevent blockage of the ears.
  6. Special earplugs (Ear Planes) may be helpful as these have a small ventilation hole through the plug, which theoretically helps to equalize the pressure. Solid earplugs should never be worn on a flight as they prevent equalization and might cause a perforation.
  7. Never fly with a bad cold or an ear infection as it can lead to severe and permanent damage of the inner ear.

If you would like any further information, please do not hesitate to contact me:

Mr Philip J Robinson MB, FRCS, FRCS (Otol)
PA: Mrs Beverley Bloor 
Tel: 0117 9804050 The Glen

Spire Bristol Hospital
Redland Hill

Appointments: Tel: 0117 9804070