Why Do My Ears Feel Blocked and Why Am I Dizzy After Flying?

Short answer: The dizziness and ear pressure you feel after flying are caused by a failure of the Eustachian tube — the narrow channel that equalizes pressure between your middle ear and the outside world. When it’s blocked or swollen, pressure builds behind your eardrum, causing pain, muffled hearing, ringing, and in some patients, true dizziness. This is treatable — and for frequent flyers who keep experiencing it, there is a definitive solution.

Dr. Franklyn Gergits, ENT · Understanding Your Symptoms · Airway & Sinus Wellness Review

You landed at Sky Harbor, your ears feel like they’re packed with cotton, and the world is slightly tilted. You’re not alone. Ear pressure and dizziness after flying are among the most common complaints I hear from patients — and one of the most misunderstood.

Most people chalk it up to the flight. Pop a yawn, chew some gum, wait it out. But if this keeps happening to you, your ears are telling you something worth listening to.

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What’s Actually Happening Inside Your Ear

The nasal cavity, sinus mucosa, and the lining of the middle ear are all connected — they share the same continuous mucous membrane system. The Eustachian tube is the narrow channel that runs from the back of your nose up into the middle ear space behind your eardrum. Its job is to equalize pressure on both sides of that eardrum so it can vibrate normally.

At cruising altitude, cabin pressure drops. On descent, it rises again quickly. Your Eustachian tube has to open and close rapidly to keep up — and it does this by briefly opening during swallowing or yawning, equalizing the pressure difference a little at a time.

When the tube doesn’t open properly, pressure builds up behind the eardrum. That pressure differential is what causes the symptoms: ear pain, the feeling of fullness or blockage, muffled hearing, ringing (tinnitus), and — when the pressure change affects the fluid in your inner ear — dizziness. Not just a mild wooziness. For some patients, true spinning vertigo. It’s a miserable feeling and it can last hours to days after landing.

Why Some People Get This Every Flight and Others Never Notice

The people who suffer are usually dealing with Eustachian tube dysfunction — and it comes in two forms.

The first is acute. A cold, a sinus infection, or an allergy flare causes the mucosa around the Eustachian tube opening to swell. The tube can’t open properly, and descent becomes a problem. Flying when you’re congested is the most common trigger. This is why your ears felt fine on the last ten flights and then punished you after you boarded with a runny nose.

The second is chronic. Some patients have Eustachian tube dysfunction that is always present to some degree — structural narrowing, persistent mucosal inflammation from allergies or silent reflux, or underlying nasal obstruction that keeps the tube poorly ventilated. These are the patients who dread flying, avoid it when possible, and never quite feel right in their ears even on the ground. For these patients, flying is not just unpleasant — it can be genuinely disabling.

What to Do Right Now — Before Your Flight Home

If you’re reading this in Phoenix and need to fly home, here is exactly what I tell my patients:

Afrin® Protocol for Flying (Oxymetazoline 0.05%)

• 2 days before your flight:2 sprays to each nostril, twice daily

• Morning of your flight:2 sprays to each nostril

• 30 minutes before boarding:2 sprays to each nostril

• Repeat this same sequence for the flight home

Important: Do not use Afrin for more than 3 consecutive days. It is a short-term flight tool only — not a daily treatment. Extended use causes rebound congestion (rhinitis medicamentosa) that can make things significantly worse.

EarPlanes®

• Drug-free filtered earplugs that slow the rate of pressure change reaching your eardrum

• Available at most drugstores and airport shops

• Safe for ages 1 and up

• Put them in before descent begins — not after your ears start hurting

Also: stay hydrated on the flight. Dehydrated mucosa is thicker and less mobile, which makes Eustachian tube function worse. Drink water, not alcohol, and avoid antihistamines right before flying — they dry the mucosa and can paradoxically worsen tube function despite reducing congestion.

The Longer-Term Answer: Treat the Root Cause

If OTC measures help but don’t solve the problem, or if this happens every single flight regardless of what you do, it’s time to address what’s actually driving it — not just patch around it.

When I see a patient with recurrent flight-related ear problems, we look at the whole picture on the first visit. Is there nasal obstruction limiting airflow to the Eustachian tube opening? Is there active sinus disease contributing to mucosal inflammation? Is there an allergy component or silent reflux keeping the tube edematous? All of these can be identified and treated.

For patients whose Eustachian tube dysfunction is structural — meaning the tube itself is narrowed or poorly functioning independent of inflammation — Eustachian tube balloon dilation is the definitive option. The procedure is done in the office. After you’re comfortable with mild oral sedation and topical numbing, I guide a small balloon catheter through the back of the nose to the Eustachian tube opening. The balloon is gently inflated, held for two minutes, then deflated and removed. We do the other side. You’re in and out in about an hour. No cutting, no packing. Most patients are back to normal activity the next day.

A randomized controlled trial published in Otology & Neurotology showed that balloon dilation improved Eustachian tube symptom scores by -2.9 points versus -0.6 for medical management alone — a statistically and clinically significant difference. For patients who’ve been struggling with this for years, the results can be life-changing.

When to Call Us Before Your Next Flight

If the symptoms from this trip are still present — ear fullness, muffled hearing, pressure, or dizziness that hasn’t fully resolved — don’t wait. Persistent pressure behind the eardrum can cause fluid accumulation in the middle ear space, and that fluid does not always go away on its own. It can lead to hearing loss, ear infections, and in some cases, structural changes to the eardrum.

The message is simple: if this is severe, address the root cause before you fly again. We can evaluate you, identify exactly what’s driving the problem, and give you a plan — whether that’s optimized medical management, balloon dilation, or both. Don’t spend the next trip dreading descent. Call us.

Want to Understand More?

This post is part of the Understanding Your Symptoms series on the Airway & Sinus Wellness Review.

→ Can Sinusitis Cause Daily Headaches? — Airway & Sinus Wellness Review

→ Can Sinus Infections Cause Brain Fog? — Airway & Sinus Wellness Review

→ Will My Obstructive Sleep Apnea Be Cured by Balloon Sinuplasty? — Airway & Sinus Wellness Review

→ Airway & Sinus Wellness Review — Full Publication

Understanding Your Symptoms · Airway & Sinus Wellness Review

About the Author

Dr. Franklyn R. Gergits, MBA, DO, FAOCO is a board-certified otolaryngologist and fellowship-trained otolaryngic allergist with a clinical focus in rhinology and airway disorders, and over 30 years of clinical experience treating sinus and airway disease in Scottsdale and the greater Phoenix metropolitan area. He is the founder of the Sinus & Allergy Wellness Center of North Scottsdale and performed the first balloon sinuplasty in Pennsylvania. He earned Center of Excellence recognition in 2 states and specializes in office-based nasal and sinus procedures under local anesthesia — including balloon sinuplasty, Eustachian tube dilation, and Neuromark posterior nasal nerve ablation. Dr. Gergits is the originator of the Posterior Sinonasal Syndrome (PSS) hypothesis — a clinical framework identifying pepsin-mediated posterior nasal mucosal injury as an upstream driver of chronic rhinosinusitis. Preprint DOI: 10.20944/preprints202603.0858.v1. ORCID: 0009-0000-4893-6332.

SinusAndAllergyWellnessCenter.com · 480-525-8999

This content is for educational purposes only and does not constitute medical advice. If you are experiencing ear pain, persistent dizziness, or hearing loss, please consult a qualified otolaryngologist. For appointments at the Sinus & Allergy Wellness Center of North Scottsdale, call 480-525-8999.