Eustachian Tube Problems Related to Flying

Individuals with a eustachian tube problem may experience difficulty equalizing middle ear pressure when flying. When an aircraft ascends, the atmospheric pressure decreases, resulting in a relative increase in the middle ear air pressure. When the aircraft descends, just the opposite occurs; atmospheric pressure increases in the cabin of the aircraft and there is a relative decrease in the middle ear pressure. Either situation may result in discomfort in the ear due to abnormal middle ear pressure compared to the cabin pressure, if the eustachian tube is not functioning properly. Usually, this discomfort is experienced upon descent of the aircraft.

To avoid middle ear problems associated with flying you should not fly if you have an acute upper respiratory problem such as a common cold, allergy attack or sinus infection. Should you have such a problem and
must fly, or should have a chronic eustachian tube problem, you may help avoid ear difficulty be observing the following recommendations:

1. Obtain from your druggist the following items: Sudafed tablets and a plastic squeeze bottle of 1/4 percent NeoSynephrine or Afrin nasal spray.

2. Following the container directions, begin taking Sudafed tablets the day before your air flight. Continue the medication for 24 hours after the flight if you have experienced any problems equalizing your middle ear pressure.

3. Following the container directions, use the nasal spray shortly before boarding the aircraft. Should your ears “plug up” upon ascent, hold your nose and swallow while attempting to force air up to the back of the throat. This will help suck excess air pressure out of the middle ear.

4. Forty five minutes before the aircraft is due to land, again use the nasal spray every five minutes for fifteen minutes. Chew gum to stimulate swallowing. Should your ear “plug up” despite this, hold your nose and blow gently toward the back of the throat while swallowing. This will blow air up the eustachian tube into the middle ear (Valsalva Maneuver).

None of these recommendations or precautions needs to be followed if you have a middle ear ventilation tube (PE tube) in your eardrum (tympanic membrane).