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During the approach phase, a passenger starts feeling ear pain and advises the cabin crew of this issue. What can the cabin crew do to help the passenger?
  • A
    Ask the pilot to stop the descent.
  • B
    Suggest to the passenger to swallow and keep moving the jaw.
  • C
    Get the passenger a sick bag.
  • D
    Tell the captain to declare a MAYDAY and request an ambulance to wait for the aircraft at the gate.

Learning Objective 040.02.03.03.01: State the role of the Eustachian tube in equalising pressure between the middle ear and the environment.


Ear pain during descent is most often caused by the difference in air pressure between the cabin and a person's middle ear. The middle ear is a closed off environment, which is sealed off by the eustachian tube. As the aircraft climbs and descends (but the worst direction is descent, due to the way the eustachian tube opens outwards), the ear has more or less pressure inside than the ambient air, which feels like a dull pain within the ear, and sound becomes a little muffled. The eustachian tube can be opened by making large movements with the jaw, or by the action of swallowing. This will then equalise the middle ear pressure with that of the ambient air, removing the pain. This often occurs naturally when talking or eating, but is easy to induce manually.

Another way of equalising pressure is the Valsalva manoeuvre (pinching the nose and blowing out through it), but this can be a bit harsher.

People suffering from a cold or ear infection may struggle to equalise their ears at all due to a blocked eustachian tube, so may feel some discomfort for a while. Usually, this should clear over a few minutes/hours, but in extreme cases, could cause damage the eardrum due to the difference in pressure. This is very rare indeed, and unlikely to occur, especially when pain only begins on the approach.

The problem is also that the aircraft has to land anyway, so cannot stop the descent, and it is not bad enough in this scenario to require a mayday call and emergency ambulance, so this is all the cabin crew can do to help.

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