AA_ORDlady

I have the same issue, primarily on descent.
I cannot clear using vasalva either.

While it doesn't happen every time, I had an extremely painful incident a couple years ago that was frightening. Vasalva, yawning, gum chewing did not help. Occasionally I would still be very clogged up for a day or two after landing.

After researching and consulting with MD, I use the following method, and have been fine. I fly probably 15-20 legs per year.

Assuming AM flight:
Night before, use Mucinex DM (I have seen various versions recommended). Also do a blast of Afrin nose spray (I have seen Nasocort recommended as well).
Before boarding, another dose of Mucinex (per dosage timing on package) and another blast of Afrin. Also take Sudafed. If it is a long flight or multiple flights you may need to take more Sudafed.

This has worked so far. I suspect that I have chronic sinus congestion that contributes to my problems.
It may be overkill but I don't ever want to go through that pain or end up with a ruptured eardrum.

skimthetrees

Try not to fly when you have a cold as your sinuses are blocked and this makes the problem 10x worse.

IME, ascent is not a problem, even the worst sinus blockage I have had will equalize on the way up eventually. It may feel weird but it is much easier to equalize pressure going up. It will happen if you relax and swallow occasionally. Your sinus was built to equalize more easily in this direction.

Descending with a plugged sinus is where it gets bad. Bad being painful and potentially damaging to your ear. If your ears are not equalizing on the way down because your sinuses are blocked you may need to help them.

The scuba approach above is the basic approach I use. Take a breath, pinch your nose closed, keep your mouth closed so no air escapes and blow (exert pressure with your lungs like you are blowing up a balloon), gradually increasing the pressure you are blowing until the air escapes through your sinuses into your ears.

If you are lucky both ears will equalize at the same time and you will be good for another minute or two of descent until you need to equalize again. If one of your sinus is significantly worse than the other (like mine when I have a cold) then only one ear will clear when you blow and if you keep increasing the blowing pressure you risk damaging the ear that has cleared (equalized) while you build enough pressure to clear the remaining ear. To work around this problem you need to take an extra step. If one ear clears but the other will not then you set up for a blow but now you must prevent the cleared ear from being damaged when you blow higher pressure to clear the bad ear. To do this you need to also apply pressure with your thumb to the cleared ear strong enough to prevent the higher pressure blow from allowing the good ear to expand too far the ear canal. The thumb will push on the flap that covers the outside of your ear canal on the already cleared ear. You need to put enough pressure with your thumb that when you blow hard enough to clear the bad side ear you don't damage the good side ear. If I have a cold I have to do this all the time on descent and it works. You will know if you are putting enough thumb pressure on the good side ear because you can feel (or you should be able to feel) when the pressure on the cleared ear gets too high. When in doubt press really hard with your thumb. You are not just keeping the ear canal closed with the ear flap, you are putting pressure in the outside ear canal to balance the pressure from the inside you are blowing with. I may not be explaining very well but this procedure has saved my ears countless times. It works. At some point, many years ago, this procedure was listed in the United Airlines in flight magazine.

You can also get tubes inserted in your Eustachian tubes to keep your ears clear all the time but then you have to keep the water out (possibly no swimming).

travelmom4

Another traveler with sensitive ears here. I had a very painful descent several years ago which caused nerve pain in my upper teeth-so bad that I had tears streaming down my face. Ever since I have used nasal spray (nasonex/flonase) beginning a couple of days before flying combined with Mucinex the night before and day of my flights. I am so gun-shy that I have a significant Mucinex stash in each of my bags along with back-up bottles of nasal spray! My system has not failed me in over 10 years.

treadlightly

I used to use Sudafed or Afrin. My Drs asked me not to as they can raise blood pressure. I now use Astelin Nasal Spray, azelastine hydrochloride. It's by prescription and non addictive. I use it the day before a flight and day of, and as needed for life other than in the air.

I also regularly get my ears cleaned by an ENT. I used to try to clean my ears myself, then had a Dr or nurse use the forced water method to clean ears. I did not like that. Over the years I have more or less a need for the ENT cleaning. They can tell over time by what they remove what a frequency for cleaning might be optimal. This has made a difference to how I feel in the air.

aquamarinesteph

Thanks for the suggestions on Mucinex. He hasn't tried that one yet! :-)

Thanks for the recommendation for the Astelin! I'll tell him to ask about that during his visit!

And thank you everyone for your responses to this thread! :-)