When the Eustachian tube fails to open or close properly, the pressure in the middle ear becomes imbalanced. This can lead to a range of symptoms, including:

Pinch your nostrils shut, close your mouth, and gently try to blow air out through your nose.

When the Valsalva maneuver is ineffective or ill-advised, several safer, low-force alternatives exist. The Toynbee maneuver combines swallowing with pressure: pinch your nose and swallow at the same time. The motion of the throat often pulls the tube open without the need for forceful exhalation. Another effective method is the Frenzel maneuver, which is like the Valsalva but uses the back of the tongue and throat muscles to press air upward, offering more control. For chronic cases, over-the-counter nasal decongestant sprays (like oxymetazoline) can shrink swollen nasal tissues, opening the Eustachian tube’s entrance. Used 30 minutes before landing or after a flight, they can be a miracle cure—but they should not be used for more than a few days to avoid rebound congestion.