QUESTION
1 What is the condition this man suffers from? What causes it and how can it be relieved?

ANSWER 
1 Barotrauma is caused by pressure on the eardrum as air pressure in the cabin increases on the aircraft's descent. It is more likely to be suffered by people who have had repeated ear infections in childhood, or who have suffered inner-ear damage or injury from other causes. It is also worsened by a current or recent upper respiratory tract infection.
€¢ It is often relieved by the use of a decongestant nasal spray (eg, xylometazoline) just before descent begins or an oral decongestant (eg, pseudoephedrine) taken about an hour before descent. Chewing or sucking (eg, a toffee or boiled sweet) or yawning also helps to equalise pressure in the Eustachian tube and ease pain.
€¢ Valsalva's manoeuvre can also be used: the nostrils are held tightly closed with the thumb and forefinger while the person tries to blow out through the nose with the mouth closed. An autoinflation device is also available and can be used to relieve barotrauma.