Ear and sinus problems in the aeroplane
When climbing to altitude the air pressure in an aeroplane decreases. This creates a relative positive pressure in the middle ear and the sinuses. Air escapes from the sinuses and the middle ear via the sinus openings in the nose and the Eustachian tube, which connects the middle ear to the nose/throat cavity. This restores the balance in the pressure.
When the aeroplane descends, the air pressure in the aircraft increases again and the air needs to flow from outside into the middle ear and sinuses again.
If the nose or the Eustachian tube is blocked, this cannot happen effectively and can result in earache with a dull sensation of pain in the sinuses. In rare cases, the eardrum can tear. This risk is greater if you have a cold.
The problems are usually more pronounced when the aircraft descends than when it is climbing.
Prevention
Cold
Try to avoid flying when you have a cold, or have your ears - or your child’s ears - checked by a doctor first.
Equalise the pressure
Try to make lots of swallowing movements and yawn often when the aircraft is climbing or descending. Blow your nose regularly, chew on chewing gum or drink whilst pinching your nose closed. Try to swallow with your mouth closed and your nose pinched.
Pressure-regulating ear plugs
Pressure-regulating ear plugs are sometimes sold at airports. There is no evidence that they really work.
Sprays
You can consider using a decongestant nasal spray. This is not recommended for young children.
Children
Ensure that babies and young children have something to drink or suck on whilst the aircraft is climbing or descending.
Consult your doctor
If you expect a lot of problems based on previous experiences, you can ask your doctor about medication to combat swelling in your nose.