Blocked ears after flying: what to do and when to see a doctor

After a flight your ear may feel plugged: sounds are muffled, the ear aches or rings. Most of the time the cause is simple: the air pressure changed during take-off and landing and the Eustachian tube could not equalise the pressure in the middle ear in time. It usually settles on its own within hours to days, but sometimes you need a doctor.

Why ears block on a plane

Air pressure changes on take-off and especially during descent. Behind the eardrum lies an air-filled middle ear. If the Eustachian tube is swollen shut (cold, allergic rhinitis, sinusitis, or adenoids in children), air cannot move in and out in time and the eardrum is pulled inward. You feel fullness and pain, and sometimes fluid or a little bleeding appears in the middle ear. This is called ear barotrauma.

What helps during the flight

• Swallow, yawn, chew gum or suck a sweet during take-off and especially during descent.
• A gentle Valsalva manoeuvre: breathe in, close your mouth, pinch your nose and softly blow into your nose without force. Never do it hard or suddenly.
• Stay awake during descent: while asleep you swallow less often and the tube opens less.
• Give babies a bottle or breast during take-off and landing; older children can drink or suck on something.
• If you have a blocked nose, a doctor may advise a decongestant nasal spray before descent (short term, as directed). Do not use it for more than a few days in a row.

If your ears are blocked after the flight

• Yawn, chew and do the gentle Valsalva several times a day.
• Rinse the nose with saline if you have a cold.
• Do not poke the ear with cotton buds or put drops in without an examination.
• Avoid diving and further flights until the ear recovers, if the blockage is severe.

When to see an ENT doctor

• Blocked ears or reduced hearing last more than 2–3 days.
• Severe or worsening ear pain.
• Ringing in the ear, dizziness or vomiting.
• Discharge or blood from the ear, or sudden relief of pain after a “pop” (the eardrum may have ruptured).
• Sudden hearing loss in one ear: it needs to be checked as soon as possible.
• A child with ear pain, crying or fever after a flight.

The doctor looks into the ear with an otoscope, may check hearing and the middle ear, and explains whether treatment is needed. More about the examination: ENT endoscopy in Nha Trang.

Preparing for your next flight

• If you have a cold, allergy or sinusitis, try to recover before flying, or ask a doctor if the trip cannot be moved.
• Do not take medicines “just in case” without medical advice.
• If ear problems repeat after flights, see an ENT doctor to check the nose and Eustachian tube.