A general history with a focus on the specific symptomatic complaints and the maneuvers performed in attempting to relieve any otologic symptoms during airplane flight/diving will be taken, an ear, nose and throat (ENT) exam, including tympanometry, done to confirm intact tympanic membranes and a disease-free ME and nasal exam done to rule out concurrent nasal inflammation. Then, sonotubometry, the 9-step test, tubomanometry and the "sniffing", Valsalva and Toynbee maneuvers will be done to establish baseline ETF. If a patulous (by observation of synchronized breathing and tympanic membrane movements) or physically obstructed ET (by an inability to transfer gas through the ET at normal driving pressures) is suggested by the results of these tests, the subject will be dismissed from further ETF testing and will be referred to their ENT physician or to the ETD clinic at Children's Hospital of Pittsburgh if they want to pursue a more complete workup to evaluate the underlying cause of the condition and possible treatment options. Those who are able to continue will have the ET stress test. Briefly, the presence/absence of ET openings by swallowing will be assessed by sonotubometry at stepped decreases from 2500 daPa (ref. ambient) to local ambient to determine the relative efficiency of muscle-assisted ET opening. The highest applied pressure at which the ET can be opened will be the outcome variable. If the individual completes the applied pressure sequence without experiencing a problem in opening their ET by swallowing or other maneuvers typically used by him/her to open their ET, the subject will have a simulated flight/dive relevant to their expected exposure.