I often hear from my patients that they are reluctant to fly in airplanes because of the ear pain they experience during take-off or landing. Aerotitis is the medical term for ear problems during flight. It interferes with the periodic opening and closing of the Eustachian tubes, which regulate the air pressure between the middle and outer ear. Normally, the Eustachian tubes open and close about every three minutes, usually when yawning or swallowing. When the Eustachian tubes cannot open, pressure may build up in the ear canal and result in hearing impairment.
Many people develop aerotitis when the pressure in the cabin increases as an airplane is descending. Repeated swallowing can open the Eustachian tubes—you may even hear a ³pop² as this occurs. If your ears still plug up, hold your nose and blow forcibly to blow air up the Eustachian tubes. This should equalize the pressure. Babies often cry as their way of opening the tubes. Providing a bottle will encourage an infant to swallow, which can also help regulate the pressure in the ears.
People with a history of Eustachian tube problems or who are suffering from allergies may need to take special precautions before they board a plane. I recommend taking pseudoephedrine tablets (such as Sudafed) 8-12 hours before flight time, and using a nasal spray that shrinks the mucous membrane (Afrin, for instance) one hour before boarding. If the flight is more than 12 hours, the nasal spray can be used again forty-five minutes before landing. Chewing gum can also help keep the Eustachian tubes open. People suffering from a cold are cautioned not to fly as this can result in severe discomfort, hearing loss, and in extreme cases, rupture of the eardrum.
People with high blood pressure, heart problems or sensitivities to these medications should not take them without consulting their doctor. But for the rest of us, knowing the physics behind aerotitis should help bring relief for ear pain on that next flight.