Often airplanes ear stuffy, friends and family will suggest that we “blow the ear”, ear stuffy uncomfortable feeling can immediately disappear. As the saying goes, “blowing your ears” means pinching your nose and shutting your mouth while blowing, so that the gas will rush into your ears along the pipes between your ears and nose. However, this is not suitable for everyone. Sometimes, if you don’t do it right, you may break your eardrums! Let’s talk about when you can’t “blow your ears out” if you have a stuffy ear on an airplane. A few days ago, there was a handsome pilot in my emergency room with a pained look on his face. He was flying international routes and had been on a flight for three consecutive days, which was very hard. Everything was fine before he got on the plane, but he came down with a bad cold and a runny nose during the flight. The flight doctor told him that he could pinch his nose to puff up his ears during the flight, so he blew his nose and pinched his nose to puff up his ears at the same time. As a result, the ear congestion was not relieved, but his ear was in excruciating pain. I examined him carefully, and found that there was a lot of yellow pus in both nasal passages, and the tympanic membranes (commonly known as eardrums) of both ears were congested and sunken, and the tympanic membrane of the right ear was extremely thin. This is acute sinusitis and acute otitis media. He should never pinch his nose and blow air in his current condition. Acute otitis media in adults is rare, and most often occurs in the context of acute air pressure injuries, such as scuba diving, airplane riding, bungee jumping, and alpine skiing. It often occurs in daily life after pinching both sides of the nose and blowing it hard. Acute inflammation of the tympanic membrane occurs as a result of the strong impact of air pressure, and such situations should be avoided as much as possible. The pilot’s long years of flying led to long-term negative pressure in the middle ear cavity, so the eardrum was invaginated, and the eardrum was blown up by pinching the nose and blowing when the ear was stuffy. The eardrum was exposed to frequent and drastic changes in the air pressure in the outside world and the middle ear for a long period of time, and it became thinner and thinner. Normal tympanic membrane has three layers, epithelial layer, fiber layer and mucous membrane layer. In a thinned eardrum, the fiber layer is reduced and only a thin layer of epithelium is attached to the mucous membrane. Such a tympanic membrane is not only inefficient in transmitting sound, but also very easy to be perforated by the impact of airflow, which may be done one time when blowing the nose inadvertently. Therefore, flight attendants should have regular checkups with professional otolaryngologists. If the tympanic membrane is thin, it is not recommended to pinch the nose to puff up the air, and for those with extremely thin tympanic membranes, they should be extra careful not to exert too much force when blowing their noses or sneezing. In addition, the pilot also suffered from acute sinusitis, at this time, if the pinch nose drumming is very easy to nasal pus “blow” into the middle ear cavity, the pus with a large number of bacteria, this time not only on the tympanic membrane is the air pressure injury, but also easy to lead to bacterial infection in the middle ear cavity, resulting in acute otitis media. Therefore, during a cold, especially when there is a lot of snot, you should not pinch your nose and puff. If you have a sudden cold during a long-haul flight and your ears are stuffy at the same time, what should you do? For flight attendants and frequent air travelers, you should always have nasal sprays and oral antidepressants on hand. There are two main types of nasal sprays, one is decongestant, such as 0.5% ephedrine nasal drops, seroquel hydrochloride nasal spray, etc.; the other is nasal spray hormone, such as budesonide nasal spray, mometasone furoate nasal spray, fluticasone propionate nasal spray, etc. The former is fast acting and has a long duration of action. The former has a fast onset of action and a short duration of action, and is suitable for people who usually have good nasal ventilation and only experience nasal congestion and stuffy ears for a short period of time. For long-term nasal congestion, especially allergic rhinitis aircrew and passengers, nasal spray hormone is better. Oral pro-discharge medications are commonly available in the form of standard myrtle oil capsules and eucalyptus-pinocampus capsules, and for children, you can drink liquid Olonma, which works mainly to promote the discharge of secreted mucus from the nasal passages as well as the Eustachian tubes that lead from the nasal passages to the ears. If you have a very hard time with ear stuffiness, you can do several times of swallowing saliva and yawning, which can also open the Eustachian tube for a short period of time and relieve ear stuffiness, but without the risk of middle ear infection.