How long should someone with otitis media wait before flying?

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Last updated: June 25, 2025View editorial policy

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From the Guidelines

Individuals with otitis media should wait until their symptoms have resolved and the fluid in the middle ear has been significantly reduced or cleared before flying, as air travel can result in ear pain or damage to the eardrum depending on how much fluid is present 1. When considering flying with otitis media, it's crucial to understand the risks associated with air travel, such as ear pain or potential damage to the eardrum, especially if there is significant fluid buildup in the middle ear.

  • The primary concern is the potential for the eustachian tubes to be blocked or inflamed, which can lead to complications during air travel due to pressure changes.
  • According to the clinical practice guideline for otitis media with effusion, watchful waiting can be an appropriate approach, but it involves regular checkups every 3 to 6 months until the fluid in the middle ear goes away, which can take months to years 1.
  • For those who must fly, taking measures to equalize ear pressure, such as swallowing frequently, yawning, or chewing gum during the flight, can be beneficial.
  • Additionally, using decongestants or nasal sprays before flying may help alleviate some symptoms, but the primary recommendation is to wait until the condition has improved significantly to avoid potential complications.
  • It's also important to note that the guideline suggests that adenoidectomy can reduce the need for future ear surgery by about 50%, but this is a more invasive procedure and should be considered based on individual circumstances and consultation with a healthcare provider 1.

From the Research

Waiting to Fly with Otitis Media

To determine how long someone with otitis media should wait before flying, it's essential to consider the effects of air pressure changes on the middle ear.

  • Otitis media with effusion (OME) is a condition where fluid accumulates in the middle ear without signs of acute infection 2.
  • The time to resolution of OME can vary, with a mean time of approximately 8.23 days reported in one study 2.
  • There is no direct evidence on the exact waiting period for flying after being diagnosed with otitis media. However, it is crucial to ensure that the condition has been treated and resolved before flying to avoid potential complications due to air pressure changes.
  • Middle-ear barotrauma is a common problem reported by aircrew members and passengers, with 20-50% of passengers reporting ear complaints during or after a flight 2.
  • Otolaryngologists recommend that aircrew members should only return to flying duties after complete resolution of otitis media with effusion, confirmed by immittance testing 2.

Considerations for Flying

When considering flying with otitis media, it's essential to:

  • Consult a healthcare professional for proper diagnosis and treatment 3, 4, 5.
  • Ensure that the middle ear fluid has been cleared and the eustachian tube is functioning properly to equalize air pressure 2.
  • Follow the recommended treatment guidelines, which may include antibiotics, pain management, and monitoring for potential complications 3, 4, 5.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Otitis Media with Effusion in Aircrew Members.

Aerospace medicine and human performance, 2019

Research

Otitis media: diagnosis and treatment.

American family physician, 2013

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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