Hearing management

Updated 15 December 2016

How flying affects your ears

So many airline passengers experience discomfort and/or pain in their ears, especially on takeoff or landing, that it is referred to as 'aerotitus' in medical circles.


Healthy Hearing points out that no matter if you’re flying first class, business class or cattle class, one thing that can affect anyone is discomfort in your ears. 

Up to a third affected

Not everyone is affected equally, and symptoms can range from barely perceptible ear popping to excruciating pain – and even temporary hearing loss.    

Up to a third of airline passengers are affected by discomfort and/or pain in their ears, especially on takeoff or landing; in fact it is so common that it is referred to as aerotitus in medical circles.

Wat actually happens inside your ears?

According to Prevention it all boils down to air pressure. Usually there is little difference between the air pressure in the inner ear and the air pressure outside your body, and under normal circumstances any changes in air pressure in the environment happen quite slowly, giving the inner ear plenty of time to adjust.

Read: Flying is a headache, literally

When flying, however, sudden changes in air pressure due to changes altitude cause the air inside the ear to rapidly expand or contract. The way the difference in air pressure is equalised is through the Eustachian tubes that connect the middle ear and nose. Pain or discomfort is caused when this process is impeded or cannot happen quickly enough.

In recent times, more rapid descents by planes have exacerbated the problem.

Solving the problem

There are a number of ways to get the air moving through the Eustachian tubes to equalise the pressure.

The easiest way to open the Eustachian and tot get more air into the inner ear is to swallow or yawn. When flying, this process needs to happen more frequently, and chewing gum or sucking sweets may help things along.  

Read: Terrified of flying?

There are two other methods you can try to unblock your ears. One is the “Valsalva maneuver” where you shut your mouth, pinch your nose shut and pressurise the air in your mouth until your ears pop. The other, slightly safer, method is the “Toynbee maneuver” where you close your mouth and nose and swallow a few times until the pressure is equalised.

When your Eustachian tubes are blocked

Your Eustachian tubes may be blocked as a result of for instance allergies, congestion or ear infections. This can be dangerous, and it is therefore better to avoid flying if you have any kind of respiratory congestion.  

If, however, it’s impossible to avoid flying, the following steps are recommended:

  • Starting on the day before your flight, take a decongestant every six hours and continue for 24 hours after your flight.
  • Avoid sleeping during take-off or landing.
  • Drink a lot of fluid to stay hydrated.
  • Just before you go on board, use nasal spray to help open your Eustachian tubes.
  • Use special earplugs that are designed to equalise ear pressure during the flight.
  • Chew gum during the flight to help keep your Eustachian tubes open.
  • Just before arrival, again use nasal spray.

Bear in mind that a blocked Eustachian tube can completely prevent equalisation of pressure, which can lead to a ruptured eardrum or a serious infection. This can cause permanent damage and hearing loss. If you experience any pain and/or your hearing doesn’t return to normal within a few days after flying, you need to seek medical assistance.

Read more:

Your body on a long flight

Be plane savvy

Does aeroplane noise cause high blood pressure?


Ask the Expert

Hearing Expert

Dr Kara Hoffman graduated from UCT in 2004, thereafter she completed her year of community service in Durban. In 2010 she completed her Masters Degree in Paediatric Aural Rehabilitation from UKZN. In 2016, she became a Doctor of Audiology through the University of Arizona (ATSU). Dr Hoffman and her partner Lauren Thompson opened a fully diagnostic audiology practice called Thompson & Hoffman Audiology Inc. In 2011 with world-class technology and equipment to be able to offer the broad public all hearing-related services including hearing testing for adults and babies, vestibular (balance) assessments and rehabilitation, industrial audiology, hearing devices, central auditory processing assessments for school-aged children, school screening, neonatal hearing screening programmes at Alberlito and Parklands Hospital, cochlear implants and other implantable devices, medicolegal assessments and advanced electroacoustic assessments of hearing. Thompson and Hoffman Audiology Inc. are based at Alberlito Hospital in Ballito, St Augustines Hospital in Durban and at 345 Essenwood Road, Musgrave. The practices are all wheelchair friendly. There are three audiologists that practice from Thompson & Hoffman – including Dr Kara Hoffman, Lauren Thompson & Minette Lister. The practice boasts professional, highly qualified, and extensive diagnostic services where all your hearing healthcare needs can be met. The additional licensing in vestibular assessment and rehabilitation, paediatric rehabilitation and cochlear implantation places this practice in one of the top specialist audiological positions in South Africa, with a wealth of experience in all clinical areas of audiology and is a very well respected and sought-after practice.

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