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Ear discomfort or airplane ear is caused by stress on the ear drum that occurs when air pressure in your middle ear and air pressure outside are out of balance.^1,2

It usually happens during takeoff and landing.

There is a small passage from the ear drum to the back of the throat called the Eustachian tube that regulates air pressure on a regular basis. So, during descent and ascent of an airplane pressure changes very rapidly so the tube can’t react fast enough which causes the discomfort.

Symptoms 1

1. Pain in the ear.
2. Feeling of fullness and stuffiness.
3. Muffled hearing.
4. In severe cases it can cause ringing in the ear spinning sensation (vertigo), bleeding, but that is very rare.

Tips do decrease discomfort during flying

1.     Swallowing, yawning: that opens the Eustachian tube and allows the middle ear to get more air to equalize ear pressure.^1,2,3

Give small children a bottle or pacifier to suck on while upright, encourage drinking lots of fluids to keep swallowing.  Allow older children to chew gum or suck on hard candy or lollipop to keep swallowing. They can also blow a balloon.^2,3

2.     Older children and teenagers can do the Valsalva maneuver: where you gently blow your nose while pinching the nostrils and keeping the mouth closed.^1,2

If they have a cold or allergies, they can do the TOYNBEE maneuver: where you close the mouth and pinch the nose and swallow several times.²

3.     Don’t allow your child to sleep during takeoff and landing so they can do the above measures.

4.     Reconsider your travel plans if your child has a cold or sinus infection, allergies flare up or middle ear infection which could cause them to have more severe symptoms while flying.

5.     Have your child use over the counter nasal decongestant spray about 30 minutes before takeoff and landing if they have nasal congestion. If they have allergies, they need to take their allergy medication 1 hour before the flight.^1,2

To ease discomfort during a flight, your pediatrician can prescribe a non-steroidal anti-inflammatory medicine like Ibuprofen, or pain-relieving ear drops.^1,2

If your child has tympanostomy tubes, it will help the air pressure equalize more easily and cause less discomfort.³

You can always consult your pediatrician before flights so they can help with tips and medications if needed.  

Dr. Rima Halat

MD pediatrician 

¹https://www.mayoclinic.org/diseases-conditions/airplane-ear/symptoms-causes/syc-20351701

²https://www.healthyhearing.com/report/52447-Airplanes-and-ear-pain-why-it-happens-and-what-you-can-do

³https://kidshealth.org/en/parents/flying-ears.html