Airplane Precautions

Dr. Richard Nass, sinus, ear, nose, and throat specialist in Manhattan discusses precautions to take when you fly.

When we travel in an airplane our bodies are subjected to atmospheric pressure. Our ears must be capable of equalizing that pressure successfully in order to avoid injuries to the ear drum, middle ear, or inner ear. The most dangerous part of the flight is when the airplane starts to descend before landing. 

Common symptoms such as ear pain and pressure, hearing loss, and balance disturbances can result from the ear’s failure or inability to equalize the changes in atmospheric pressure. Sometimes the symptoms are temporary and require no treatment, and sometimes they require medications, or even surgery.  The damage can sometimes be permanent.

The Eustachian tube in our ears connects the nasopharynx (located behind the nose) to the middle ear.  It allows atmospheric pressure in the ear to be equal to that of the nasopharynx.  But problems or malfunctions can occur with a sinus infection, cold, allergy, or scarring from past infections. Malfunctions from tumors in the nasopharynx or middle ear can also be a cause, but they are far less common.

If you have acute sinusitis, an acute upper respiratory infection, or an allergy attack you should not fly. If, for some reason, you can’t cancel the flight consult an ENT doctor to assess your risk. In order to fly safely, you may need to have a simple office procedure such as having a ventilating tube place in your ear.

If you have a chronic Eustachian tube dysfunction, the long-term treatment should be determined and addressed by your doctor.

If your problem is less severe, other precautions will allow you to fly safely. These are all short-term and should be discussed in advance with your doctor.   

  • Don’t drink alcohol on the day of the flight or during the flight. Alcohol will increase congestion.
  • Don’t use tobacco on the day of flight. Of course you should avoid tobacco altogether.
  • The action of chewing gum or sucking on a candy causes the Eustachian tube to be pulled open. Do this on both take off and descent.
  • Use Earplanes® brand earplugs on takeoff and descent and follow the directions on the box. These are not just ordinary earplugs and were designed by ear doctors to equalize pressure while flying. They’re readily available without a prescription at drugstores, online, and at airport shops.
  • Your doctor may advise you to supplement your other precautions with Sudafed® or Sudafed® Long-Acting. Just make sure your doctor knows you’re planning to take it and it doesn’t conflict with other medications or any health conditions you might have.
  • If you are cleared to take Sudafed®, take two (2) 30mg Sudafed® tablets one hour before take-off for flights lasting up to three hours, or one long-acting (12 hour) Sudafed®.
  • For very long flights or trips with multiple legs contact my office for instructions.
  • There are occasions when I’ll recommend the use of Afrin® brand nasal spray on take-off or descent. Afrin® has fewer negative side effects than other over-the-counter nasal sprays.

To learn more about ear precautions to take before flying call Dr. Richard Nass M.D. at (212) 734-4515.