Dear Doctor Column, January 31, 2005

Avoiding "Airplane ear" When Flying

Question:

If my husband has an ear infection, can he still fly? He says he can, but I thought you shouldn't fly with an ear infection. Who's right?

Answer:

Only your husband's doctor can say for sure whether he can fly with an ear infection. It depends on the type of infection he has, how much fluid is in his ear, and the stage of the infection.

The cause of barotitis media or "airplane ear," is unequal pressure between the middle ear and the airplane's cabin. Usually, the eustachian tube, which connects the middle ear to the back of the throat, equalizes the pressure, but when you have an ear infection, the combination of fluid and unequal pressure creates a vacuum and stretches the eardrum. Conversely, during descent, the eardrum is pulled inward, causing pain, and sometimes, temporary hearing loss. Others susceptible to pressure changes are people with colds, allergies, or sinus infection.

Therefore, air travel typically is not recommended until the middle ear has healed. The doctor can advise your husband if it's safe for him to fly.

To prevent or ease pressure problems, swallowing, yawning, and chewing gum help the eustachian tube remain open, keeping pressure in the middle ear equalized. Also, try using an over-the-counter nasal decongestant spray or pill an hour before landing, which helps shrink mucous membranes and relieve some of the pressure on the eardrum.