Ask DAN: Middle-Ear Squeeze

DAN medical information specialists and researchers answer your dive medicine questions.

September 27, 2023
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Flying with Middle-Ear Squeeze

"I think I have a middle-ear squeeze from yesterday’s dive, and we are due to fly home in a couple of days. I have stopped diving because of the symptoms. My ear feels clogged, and I don’t feel like I can equalise. Am I going to be safe to fly?

You were wise to stop diving. Continuing to dive with a pre-existing ear squeeze (barotrauma) can aggravate the symptoms and even cause permanent injury. If you experience serious or worsening symptoms such as balance problems, vertigo, intense pain, nausea, hearing loss (not just muffled hearing) or persistent ringing or roaring in the ear, seek prompt medical attention from a local physician before flying. Fortunately, the symptoms you describe fall into the less-serious category. A clogged sensation in the ears, the sensation of “water in the ears,” muffled hearing and a clicking or bubbling noise are less likely to be a problem for a flight planned two days in the future, but these symptoms may still warrant evaluation and treatment from a local doctor.

Whether flying or diving, you need to be able to equalise the pressure in your ears. The pressure changes inside a commercial aircraft cabin are far less dramatic than those encountered while diving and are typically not enough to cause further injury in the case of mild, properly treated barotrauma, but an inability to equalise will create significant discomfort. To reduce symptoms and improve equalisation, a doctor will usually recommend over-the-counter medications such as decongestants and/or anti-inflammatories. More serious symptoms may require prescription medications.

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