Preventing Ear And Sinus Pain While Flying

First, let us explain to you how ear pain occurs when the plane descends for landing. There is a tube that connects the back of your throat to the area just behind your eardrum that is called the eustachian tube. The eustachian tube function is to equalize the pressure in the air behind your eardrum with the air around you. Because of inflammation or infection, swelling around the tube will occur causing the tube to not function properly.

Air pressure is not able to equalize behind the eardrum, causing ear pain as the eardrum adjusts to the abnormal pressure changes. When the pressure equalizes behind the eardrum, we frequently say that the ears have popped. Normally when the plane is taking off and ascending, ear pain is not a problem because air can easily escape from behind the eardrum, through the eustachian tube, and into the throat. However, when the plane descends, air must be forced through the congested eustachian tube into the area behind the eardrum, which can be more difficult. Therefore, ear pain will almost always be experienced on descent if there is any problem at all.
Second, when the nose is congested, the passageways between the nose and the sinus cavities can be swollen as well. Once again, it may be very difficult to equalize pressure between the sinuses and the nose when descending, leading to sinus pain.

In order to maximize the ability of the eustachian tube and sinus passageways to work, we will give you a few helpful hints:

1. Spray Afrin nasal decongestant spray twice into each nostril one hour prior to flying.
2. Begin taking a decongestant, like Sudafed, one hour before the flight. Both of these medications can be purchased over-the-counter in a drug store.  Do not use Sudafed if you have high blood pressure, have a history of abnormal heart rhythms, have prostate enlargement, or if this medication has caused you to feel jittery in the past.
3. As the plane descends you will want to force air into your eustachian tubes or sinuses which will allow you to equalize the pressure as the plane descends. You can do this by closing your mouth tightly and pinching your nose, to prevent air from escaping, as you blow your nose with gentle force.  It is good to do this as soon as the plane begins to descend. If you wait until the ear or sinus pressure is severe, then you may not be able to blow hard enough to overcome the negative pressure that has built up. Sometimes swallowing can achieve the same goal of equalization of the ear pressure making the previous maneuver unnecessary. Chewing gum or sucking a liquid through a straw is also helpful.
4. For infants: the child should be given a bottle to drink as the plane descends in order to clear their ear pressure with the act of swallowing. This feeding should start as the plane starts to descend or as soon as you begin to feel pressure build in your own ears. Crying will also help to clear the eustachian tubes and equalize the ear pressure.
5. Before giving any infant any decongestants, discuss this matter with your pediatrician.

We hope this information helps you with your problem with flying. Our goal is to keep you well informed about this problem so that you may avoid the discomfort that is associated with it.

PLEASE NOTE: You should avoid flying if your nose is congested from a cold or allergies. In the most severe case, this may lead to a permanent decrease in your hearing, prolonged dizziness, or severe pain. Most patients who experience a decrease in hearing associated with severe pain after a plane flight have a readily reversible hearing loss and should be seen by an otolaryngologist (ENT) within several days of the event, as this makes it easier to correct the problem.