Flying with “clogged ears” indicates a problem with pressure regulation, usually caused by congestion or inflammation from an allergy, cold, or sinus infection. This inflammation prevents the internal ear from balancing with external air pressure. While flying with mild congestion is possible, it requires diligent preparation and specific techniques to manage pressure changes. Ignoring the underlying issue can lead to significant discomfort and potentially serious medical complications. The decision to fly depends heavily on the severity of your symptoms and your ability to actively equalize pressure.
How Pressure Changes Affect Your Ears
The mechanism behind ear discomfort during flight involves the Eustachian tube, which connects the middle ear to the back of the throat and nose. This tube ensures the air pressure in the middle ear matches the pressure outside the body. During rapid altitude changes, such as takeoff and landing, the cabin air pressure changes faster than the middle ear can adjust.
As the aircraft ascends, air pressure drops, causing positive pressure in the middle ear that vents through the Eustachian tube. During descent, cabin pressure increases, creating negative pressure inside the middle ear. This change pulls the eardrum inward, which can seal the tube closed and cause pain and the “clogged” sensation. When the tube is swollen due to congestion, its ability to equalize this pressure differential is impaired, amplifying discomfort.
The Dangers of Flying While Congested
Flying with inflamed or blocked Eustachian tubes dramatically increases the risk of barotrauma, commonly known as “airplane ear.” This pressure injury occurs when the significant pressure difference between the middle ear and the cabin air stresses the eardrum and middle ear tissues. Mild barotrauma typically presents as moderate pain, a feeling of fullness in the ear, or temporary muffled hearing that resolves shortly after landing.
Severe cases of barotrauma cause intense, sharp pain and complications lasting days or weeks. The pressure imbalance can cause fluid accumulation in the middle ear, and in extreme situations, may result in a ruptured eardrum, causing bleeding or fluid leakage. Severe pressure trauma can also lead to inner ear damage, resulting in dizziness, vertigo, or permanent hearing loss and ringing in the ears.
Active Techniques for Equalizing Ear Pressure
To counteract the pressure changes during a flight, especially during the descent phase, you must actively encourage the Eustachian tube to open. Frequent swallowing is a simple, effective maneuver because the muscles involved in swallowing help pull the tube open. Chewing gum or sucking on hard candy stimulates saliva production, prompting more frequent swallowing and aiding in pressure equalization. Yawning widely is another useful technique that engages the throat muscles to help unblock the tubes.
If passive methods are insufficient, employ the Valsalva maneuver, a controlled method of forcing air into the middle ear. To perform it, pinch your nostrils shut, close your mouth, and gently try to exhale. Use the Valsalva maneuver with caution and only blow gently, as excessive force can damage the eardrum. An alternative is the Toynbee maneuver, which involves pinching the nose shut and swallowing repeatedly until pressure equalizes. Perform these active techniques proactively, starting as the aircraft begins its descent, and remain awake during ascent and descent to sense pressure changes immediately.
Pre-Flight Preparation and Critical Warnings
To improve your experience when dealing with congestion, consider the following preparation steps:
- Take over-the-counter oral decongestants (containing pseudoephedrine) 30 to 60 minutes before takeoff and again 30 minutes before descent to shrink swollen nasal and Eustachian tube lining.
- Use nasal spray decongestants about 30 minutes before altitude change, but only for a few days to avoid the “rebound effect” that worsens congestion.
- Use a saline nasal spray or rinse in the days leading up to the flight to keep nasal passages clear and moist.
- Wear specialized filtered earplugs designed for flying, which slow the rate of air pressure change against the eardrum, allowing the Eustachian tube more time to adjust.
However, there are situations where flying is strongly advised against, even with preparation. Do not fly if you have a severe ear infection (acute otitis media), a perforated eardrum, or have recently had ear or sinus surgery, as the pressure changes can cause significant pain and serious complications. If you experience severe ear pain, vertigo, or muffled hearing that persists for more than 48 hours after landing, you should promptly seek medical attention.