Airplane ear is a preventable condition, and there are various strategies to avoid it. These preventive measures can be categorized into three groups:

A. Primary Prevention

This involves actions that can be taken before or during any ear discomfort:

Self-care Practices: Activities such as yawning, swallowing, and chewing, especially during takeoff and landing, should be performed while flying. These actions help keep the Eustachian tubes open and prevent airplane ear. Sucking on lozenges and chewing gum during ascent and descent can also be beneficial.
Stay Awake: It is advisable to remain awake during takeoff and landing to actively perform actions like yawning, swallowing, and chewing. If necessary, passengers can ask flight attendants to wake them up before landing.
Use Air Pressure Regulating Earplugs: Special earplugs, which can be purchased at airports, pharmacies, or hearing clinics, are designed to help balance the pressure against the eardrum, preventing airplane ear.
Medication: Those with a cold can use decongestants about an hour before flight takeoff to reduce the risk of airplane ear.
Note: Always consult with a healthcare provider before using decongestants, especially if you have high blood pressure, heart conditions, arrhythmias, or are pregnant.
Over-the-Counter Nasal Sprays: Nasal congestion increases the risk of airplane ear. Using a nasal spray about 30 minutes before takeoff can help alleviate this.
Use an Autoinflation Balloon: These special balloons can be inflated through the nose by blocking one nostril and blowing through the other. Available at pharmacies, they can help relieve discomfort during flights or unblock the ears after landing.
Reschedule Air Travel: If possible, consider postponing air travel if you are suffering from a cold, sinusitis, nasal congestion, or recently had ear surgery or infection, especially if you've experienced significant airplane ear symptoms in the past.

B. Secondary Prevention

This involves measures to prevent severe ear pain once discomfort is felt:

Valsalva Maneuver: If you experience ear discomfort during a flight, this technique can help equalize the pressure in the middle ear, preventing airplane ear. It involves the following steps:

Take a deep breath.
Push the breath out while keeping the mouth and nose closed.
Hold for 15 to 20 seconds.
Open the mouth and nose and exhale.

Ear Packing: If bleeding occurs, immediate ear packing is necessary to prevent further damage.

C. Tertiary Prevention

This long-term approach involves surgically placing a tube in the eardrum to assist in fluid drainage and equalizing the pressure between the middle and outer ear. This option is typically recommended for frequent flyers who are prone to severe airplane ear.

Special Tips for Preventing Airplane Ear in Infants and Toddlers

Due to their smaller Eustachian tubes, infants and toddlers are more likely to experience airplane ear. To minimize symptoms, parents or guardians can try the following measures:

Breastfeeding
Bottle feeding
Using a pacifier
Drinking fluids with a sipper or straw

For children over 4 years of age, the following activities can help:

Chewing gum
Drinking fluids through a straw
Blowing bubbles through a straw

Note: Decongestants are not typically recommended for children under 6 years old. Always consult a pediatrician before administering decongestants to a child.