Introduction. Changes in air pressure during flying can cause ear-drum pain and perforation, vertigo, and hearing loss. It has been estimated that 10% of adults and 22% of children might have changes to the ear drum after a flight, although perforation is rare. Symptoms usually resolve spontaneously.

While it is extremely rare, the rapid changes in atmospheric pressure during a flight's ascent and descent can cause an eardrum to rupture (barotrauma). This typically only happens if a passenger has a severe blockage in their Eustachian tubes—the narrow passages that equalize pressure between the middle ear and the outside world—usually caused by a heavy cold, sinus infection, or severe allergies. When the plane descends, the external pressure increases rapidly; if the ear cannot equalize, the pressure differential creates a vacuum that pulls the eardrum inward, potentially causing a tear or "perforation." In 2026, most modern aircraft like the Boeing 787 have "lower cabin altitudes," which reduces the total pressure swing and makes this even less likely. To prevent "airplane ear," travelers should use the "Valsalva maneuver" (gently blowing through the nose while pinching it shut), chew gum, or use "EarPlanes" (pressure-filtering earplugs). If you have a total nasal blockage, most doctors recommend using a decongestant spray 30 minutes before descent to ensure your ears can "pop" safely and avoid the intense pain associated with barotrauma.