When may middle ear and sinus problems occur for pilots during flight?

Middle ear and sinus issues can arise during climbs and descents primarily due to rapid changes in atmospheric pressure. As an aircraft ascends or descends, the pressure outside the body changes more swiftly than the pressure inside the ear and sinuses can adjust. This can result in discomfort or pain, known as barotrauma, if the pressures are not equalized properly.

During climbs, the decrease in external air pressure can cause the air trapped in the middle ear to expand, leading to a sensation of fullness or pain if the Eustachian tube does not open to allow for pressure equalization. Conversely, during descents, the increase in external air pressure can create similar issues, often causing discomfort as the pressure in the middle ear must also equalize.

While such problems can occasionally be experienced during other phases of flight, such as during taxiing or at cruising altitude, they are most commonly associated with the significant pressure changes that occur specifically during climbs and descents. Therefore, understanding the physiological changes that occur in the body during these phases is essential for pilots to manage their ear and sinus health effectively.