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Blocked ear and flying

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My left ear is a little bit blocked with little to no pain. I've seen an ENT (ear/nose/throat specialist) who prescribed ran-clarithromycin antibiotics and apo-mometasone nasal corticosteroid spray.

I'm seeing him tomorrow and there's been little to no improvement after 72 hours of treatment. What are the risks involved with flying? I have a flight scheduled on Wednesday, December 25.

The doctor said the ear was dark and a bit red. He couldn't see if there was fluid due to the darkness.

In addition to what was prescribed, I also used OTC nasal decongestants for a few days and have now switched to oral decongestants (pseudoephedrine hydrochloride 60 mg) . I also have been constantly using a saline nasal spray. If you have other suggestions to reduce the congestion, it would be appreciated.

Category: ENT Specialist

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Category: ENT Specialist
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Thank you for your consult at DoctorSpring

Your symptoms are -
Left ear block without ear pain

Ear block without pain in young age usually occur following getting cold which may cause block in eustachean tube (tube connecting nose and ear).

You are getting treatment for same. It is not a serious condition but hearing may become normal in 2 to 3 weeks.

You can continue same treatment and can add antihistamine medication for same including Tab.Levocetrizine 5 mg once daily for 15 days.

You can continue your trip with precaution mainly during take-off and landing of aircraft (this causes maximum pressure changes). For this you should continue medication. Keep chewing or swallowing you saliva and yawning during take-off and landing.
Keep analgesic medicine with you in case some pain starts in travel, you can use it (paracetamol 1 gm as and when required).

Summary of treatment:
• To Continue same treatment
• Continue nasal spray.
• To add - Tab.Levocetrizine 5 mg once daily for 15 days.
• To review ENT consultant for examination

Hope this helps. Feel free to ask if you have any further queries.
Thank you.
Dr. Sunil Jalan

Patient replied :

Hi there,

Thank you for your reply. I saw the ENT today and he said that the "redness is greatly reduced and there is no inflammation or bulging". He concluded that it is safe to travel "without any risks". However, he said that it is normal that I still experience some blocked symptoms because there is fluid in my ear.

He did this thing which sort of like a giant circle that if you bang it, it vibrates. He did this on both sides of my head which I heard and then did it in the middle. I somewhat felt it more on the right (unblocked side).

Finally, he recommended that I wear earplugs when swimming. (I'm going to a beach resort.)


1) Should I wear earplugs in both ears or only the infected ear? My right ear has always been fine, including today.

2) Would an extended release pseudoephedrine hydrochloride 12 hour tablet suffice as an anti-histamine?

3) Are there any contra-indications for taking pseudoephedrine hydrochloride (explained above) and xylometazoline hydrochloride (over the counter nasal decongestant spray) at the same time? I would do this only during flights.

Thanks again and Happy Holidays.


I am happy to know that you are improving.

You should use ear plug for both side as it is always safe during swimming even without any ear disease.

Pseudoephedrine hydrochloride is a good decongestant, but it is not anithistamine. it will work well. But if you add antihistamine you recovery may be faster.

There is no contra-indications for taking pseudoephedrine hydrochloride and xylometazoline hydrochloride at the same time

If your hearing is not improving even after coming back form vacation (total 15 days) then you can plan for Audiogram (hearing test) after consulting your ENT doctor.

Hope this helps. Feel free to ask if you have any further queries.

Thank you.
Happy Holidays.

Patient replied :

Hi there, thank you again for your prompt reply. I would like to clarify a few points. 1) Do I need to use earplugs in both ears? I understand that I can. However, if the infection was only in the left ear, is there any reason why I need to use an earplug in the right ear? I would rather only do it in 1, if possible. 2) I mentioned earlier that I felt the vibration of the weber test ( just a tiny bit more on my right side (the good ear). Is this normal? 3) Based on everything that I've told you, do you think that there is still any risk that I might perforate my eardrum when flying? 4) Although anything is possible, is there any risk in your opinion if I finish the antibiotics that were prescribed that this can worsen? Thanks.


Firstly, my apologies for the delay with reply.

It is not required to use ear plug in right side with present condition, it is just a safe practice.

Usually with your condition weber's test should lateralise to diseased ear in your condition. I knew that, and that is why I asked you to do an audiogram if your hearing is not improving in two weeks time. You need not to worry much about this now.

With present condition on medication you don't have risk of perforation of your ear drum, you can fly safely. You can finish you antibiotic without any side-effect.

Hope this helps. Feel free to ask if you have any further queries.

Thank you.

Patient replied :

Thanks. For my final question, what symptoms would indicate a return of the ear infection? I have now finished a 7 day period of antibiotics. I am still taking the nasal corticosteroid spray. As explained here, there is likely fluid in my ear still. Yesterday, my ear was feeling less blocked but today it is only slightly worse. Is this normal? It is not severe at all. As the symptoms were never severe, nor was there any pain, what should I use as an indicator to know if there is just fluid in my ear or a new infection that would require antibiotics?

I want to ensure that by the time I return from my trip by plane (in a week), I won't be at risk for eardrum peforation due to infection like I was before I started my antibiotics. As well, I want to ensure I can continue enjoying my trip without fear of waking up feeling worse due to something being untreated.



Ear infection may present with ear pain, blocked ear. No need to continue antibiotic. But you should continue nasal corticosteroid spray for one more month, to prevent recurrence,with this you will able to fly safely in future also.
You can continue decongestant for 5 to 10 days til your ear block clears fully.


Dr. Sunil Jalan
Category: ENT Specialist
DAA (Diploma in asthma and allergy) : Christian Medical College, Vellore, 2012
D.N.B (ENT), 2011
Residency - M.S. (Master post graduate degree in otorhinolaryngology),  Christian Medical College, Vellore, 2009
D.L.O. (Diploma in otorhinolaryngology) - Christian Medical College, Vellore, 2007
Medical School - M.B.B.S, S.P. Medical college, Bikaner, 2004
Dr. Sunil Jalan and 4 other Medical Specialists are ready to help you

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