Ear Altitude and Airplane Travel


Study of air travel comfort and safety.

Why do ears pop when you fly on an airplane? Or why, when they if at all do pop, you get an earache? Why do babies on an airplane fuss and cry so much during descent?

The most common medical complaint of all airplane travelers is problems associated with ears. They are usually simple, minor annoyances, which occasionally result in temporary pain and hearing loss.

The Ear and Air Pressure:

It is the middle ear that causes discomfort during air travel, because it is an air pocket inside the head that is vulnerable to changes in air pressure.

When you swallow, your ears make a little click or popping sound. This occurs because a small bubble of air has entered your middle ear. It passes through the Eustachian tube, a membrane-lined tube about the size of a pencil lead that connects the back of the nose with the middle ear. The air in the middle ear is constantly being absorbed by its membranous lining and resupplied through the Eustachian tube. The air pressure is constantly being equalized on the two sides of the eardrum . When, the air pressure is not equal (that is to say the air pressure in the middle ear and the atmospheric pressure outside are not equal), the ear feels blocked.

middle ear

Secretory otitis. The middle ear is filled with fluid leading to blockage and if infected causes severe pain.

Blocked ears and Eustachian tubes

The Eustachian tube can be blocked, or obstructed, for various reasons. When this occurs, the middle ear pressure cannot be equalized. The air is already absorbed and a vacuum occurs, sucking the eardrum inward and stretching it. Such an eardrum cannot vibrate naturally, so sounds are muffled or blocked, and the stretching can be painful. If the tube remains blocked, fluids percolate (ooze gradually) into the area from the membranes in an attempt to overcome the vacuum. This is called “fluid in the ear,” serous otitis, or aero-otitis.

The most common cause for a blocked Eustachian tube is the common cold; sinus infections, nasal allergies and hay fever, etc. A stuffy nose leads to stuffy ears because the swollen membranes block the opening of the Eustachian tube.Children are especially vulnerable to the blockages because their Eustachian tubes are narrower than adults.

The ear is divided into three parts: which are:

The outer ear: which is seen on the side of the head plus the ear canal leading down to the eardrum.The middle ear: the eardrum and ear bones (ossicles), plus the air spaces behind the eardrum and in the mastoid cavities (vulnerable to air pressure).The inner ear: the area that contains the nerve endings for the organs of hearing and balance (equilibrium)

How can air travel cause problems?

It is often associated with rapid changes in air pressure. To maintain comfort, the Eustachian tube must open frequently and wide enough to equalize the changes in pressure. This is especially true when the airplane is landing down, going from low atmospheric pressure down closer to earth where the air pressure is higher.

In, any situation wherein there is rapid changes in altitude or pressure changes occur it creates the problem. It can be experienced when riding in elevators or when diving to the bottom of a swimming pool. Deep sea divers are taught how to equalize their ear pressures; so are pilots.

How to unblock your ears?

Swallowing activates the muscle that opens the Eustachian tube. Swallowing movements are often created when chewing gum or letting mints melt in the mouth. These are good air travel practices, especially just before ascent and during descent. Yawning is even better. Avoid sleeping during descent, as we may not be swallowing often enough to keep up with the pressure changes.

If yawning and swallowing are not effective, unblock the ears as follows:

  • Pinch your nostrils shut.
  • Take a mouthful of air.
  • Using cheek and throat muscles, force the air into the back of the nose, as if trying to blow the thumb and fingers off the nostrils.

When there is a loud pop heard in the ears, you have succeeded. It should be repeated during descent.

Babies’ ears:

Babies cannot pop their ears, but popping may occur if they are sucking on a bottle or pacifier. Feeding the baby during the flight, and not allowing him or her to sleep during descent.


When inflating the ears, force should not be used. The proper technique involves only pressure created by the cheek and the throat muscles.

If there is a cold, a sinus infection or an allergy attack, it is best to postpone an airplane trip.If you have recently undergone ear surgery, consult with your surgeon on how soon you may safely fly.

Decongestants and nasal sprays:

Many experienced air travelers use a decongestant pill or nasal drops (Nasavion, Otrivin) an hour or so before descent. This will shrink the membranes and help the ears pop more easily. Travelers with allergy problems should take their medication at the beginning of the flight for the same reason.

Decongestant tablets and drops can be purchased without a prescription. It should be avoided by people with heart disease, high blood pressure, irregular heart rhythms, thyroid disease or excessive nervousness. People should consult their physicians before using their medication. Pregnant women should also consult their physicians.

If your ears will not unblock:

Even after landing one can continue the pressure equalizing techniques, and you may find decongestants and nasal drops to be helpful. (Avoid making a habit of nasal drops. As, they may cause more congestion than they relieve). If the ears fail to open, or the pain persists, then seek the help of a physician who has experience in the care of ear disorders. He/she may need to release the pressure or fluid with a small incision in the ear drum.