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Individuals with Eustachian tube problems may experience difficulty equalizing their middle ear pressure when flying. During airplane travel the ears are subject to large swings in barometric pressure. As you ascend, the cabin air pressure drops and a relative positive pressure builds up in the middle ears. For most people, this pressure easily escapes out through the Eustachian tube. Thus, the pressure of the middle ear equilibrates with that of the cabin air pressure (about 6000 feet above sea level).
Pressure equalization during descent is much more difficult. The cabin air pressure gradually increases during descent. Thus, a relative negative pressure develops in the middle ear that tends to lock the Eustachian tube closed. Yawning, swallowing, chewing gum, or trying to "pop" ones ears usually will help the Eustachian tube to open at some point, equalizing the middle pressure. Most adults can fly without difficulty unless they have an illness that has temporarily swollen the lining of the Eustachian tube and narrowed its passageway. Some adults have very mild Eustachian tube dysfunction and only have symptoms when flying.