University of Virginia Health System

Decongestants Ease Flying-Related Ear Discomfort

Dr. Paul Lambert, director of the otology-neurotology division at the University of Virginia Health System, suggests using decongestants. He recommends either using a nasal spray, like Neosynephrine, about 30 minutes before the plane lands or taking an oral decongestant, like Sudafed, 12 hours before departure.

According to Lambert, it is the change in cabin pressure during dissent that makes your ears feel like they're stuffed with cotton or about to explode.

As the plane ascends, the air pressure in the cabin decreases and causes the pressure in the middle ear to expand. This excess air in the middle ear passively escapes through the eustachian tube, which leads from the middle ear to the back of the nose. It is the eustachian tube that permits the air pressure in the middle ear cavity to adjust to external air pressure.

As the plane descends and the air pressure in the cabin builds back up, the opposite problem develops – not enough pressure in the middle ear. To fix it, you need to force air up through the eustachian tube into the middle ear, which is a much harder process, Lambert says.

One way to force air through the middle ear is to pinch the nose closed and blow hard, forcing air up through the eustachian tube, opening it and allowing air then to pass into the middle ear, Lambert says. But for a lot of people that just doesn't work, so I recommend using decongestants to help keep the eustachian tube open.

January 22, 1999