What is Aerosinusitis
Experiencing ear discomfort or pain during flights is a common issue known as aerosinusitis or barotrauma. This condition arises from rapid changes in air pressure, particularly during takeoff and landing, which can affect the sinuses and middle ear.
Understanding Aerosinusitis
Aerosinusitis occurs when the air pressure in your middle ear and the external environment are not balanced. The Eustachian tube—a narrow passage connecting the middle ear to the back of the nose—plays a crucial role in equalizing ear pressure. If this tube doesn't adjust quickly enough to pressure changes, you may experience symptoms such as:
They can occur in one or both ears.
- Muffled hearing
- Sensation of a blocked ear
- Ear pain or discomfort
- In severe cases, bleeding
Preventive Measures
To minimize the risk of aerosinusitis during flights:
- Yawning and Swallowing: These actions help open the Eustachian tube, allowing pressure to equalize.
- Valsalva Maneuver: Gently exhale while keeping your mouth closed and pinching your nose to help balance ear pressure.
- Stay Hydrated: Drinking water keeps mucous membranes moist, aiding in pressure regulation.
- Use Decongestants: Taking a decongestant pill or using a nasal spray before flying can reduce nasal congestion, facilitating better air pressure regulation.
- Chewing Gum: Chewing during takeoff and landing stimulates swallowing, which can help equalize ear pressure.
Symptoms - Mild vs Severe
Recognize the signs so you can act early.
Mild or common
- Discomfort or a dull ache inside one or both ears
- Feeling of fullness/stuffiness
- Muffled hearing or temporary hearing loss
Severe (seek help if you notice these)
- Sharp, worsening ear pain
- Ringing in the ear (tinnitus)
- Spinning sensation (vertigo)
- Fluid or blood from the ear
Who's most at risk?
The Eustachian tube can struggle when...
- Infants & toddlers - their tubes are shorter and flatter
- Cold or sinus infections - swelling blocks pressure equalization
- Hay fever/allergies
- Recent ear surgery or infection
- Sleeping during ascent/descent - you're not swallowing or yawning
Complications & When to See a Doctor
Aerosinusitis usually clears quickly, but untreated, it can (rarely) lead to:
- Persistent hearing loss
- Chronic tinnitus
- Ongoing vertigo or balance problems
Red-flag moments
- Severe pain that lasts > 48 hours
- Fluid, pus, or blood from the ear
- Hearing still muffled after two days
- Dizziness, fever, or drainage
If any of these occur, book an ENT appointment as soon as you land.
Pre‑Flight Checklist (24 h → Take‑off)
1. Skip your flight if you’re really congested. Re‑book if you can.
2. Hydrate the day before; avoid excess alcohol/caffeine.
3. 30 min before boarding:
- Saline nasal spray to moisten passages
- Oral decongestant (pseudoephedrine) if you have no heart/BP issues
- OTC pain reliever to blunt pressure pain
4. Pack: filtered earplugs, sugar‑free gum, water bottle, baby bottle/pacifier (if traveling with kids).
In‑Flight Quick‑Relief Steps
- During climb & descent: chew gum or suck sweets to trigger swallowing.
- Valsalva manoeuvre: pinch nose, close mouth, and gently blow until you feel the “pop” (repeat every few minutes).
- Sip water regularly; dry mucous membranes clog faster.
- Stay awake for the last 30 minutes of the flight so you can equalize pressure proactively.
Post‑Flight Care
- Still clogged? Try a warm compress over the ear and swallow/yawn frequently.
- Use a saline rinse or nasal spray twice daily for a day or two.
- If symptoms persist beyond 48 hours, arrange an ENT review.
Flying with Babies & Kids
- Feed or offer a pacifier during take‑off and, crucially, the entire descent. Swallowing is the best equalizer.
- Seat children upright for drinks; older kids can blow bubbles through a straw.
- Avoid paediatric decongestants unless a doctor okays them.
- Crying actually opens the Eustachian tube—don’t panic if it happens!
Quick FAQ
Can filtered earplugs really help?
Yes—pressure‑regulating plugs slow the rate of change, giving the Eustachian tube more time to adapt. You still need to yawn/swallow.
Is it dangerous to fly with a cold?
It increases the risk of severe barotrauma; serious cases have caused ruptured eardrums. If you must fly, pre‑dose with saline + (doctor‑approved) decongestant.
Do ear tubes prevent airplane ear?
Tympanostomy tubes can help frequent fliers with chronic problems, but they’re a surgical option reserved for recurrent, severe cases.
If you experience severe, persistent, or recurring symptoms of aerosinusitis, it's advisable to consult a healthcare professional. In some cases, medical interventions such as nasal decongestants, nasal lavage, or even surgical procedures may be recommended to alleviate symptoms and prevent future occurrences.
By understanding aerosinusitis and implementing these preventive strategies, you can reduce discomfort and enjoy a more pleasant flying experience.
See Mayo Clinic’s complete list of airplane‑ear symptoms
https://www.mayoclinic.org/diseases-conditions/airplane-ear/symptoms-causes/syc-20351701
If your aerosinusitis is severe and recurring, consult with your doctor about endoscopic sinus surgery.
