Don't take off without them. Before inserting, pinch nose and blow to clear your ears. For best results, always insert EarPlanes one hour before landing. Remove after landing and when the cabin door is opened. Chronic sufferers may also insert EarPlanes just before takeoff. EarPlanes may be removed when the airplane reaches maximum altitude and reinserted one hour before landing. For maximum results, use your opposite hand to pull the top of your ear upward. Insert the ribbed end and turn like a corkscrew until snug. Recommendation: Do not reuse after two flights since pollen, dust, and moisture will reduce effectiveness.Uses:Relieves air pressure discomfort with the exclusive CeramX filter. Reduces harsh noise. Drug free. World's #1 seller. Tested by U.S. Navy Pilots. Approved by flight attendants. Safe, comfortable, disposable. Soft, hypoallergenic latex free silicon. This pack contains one pair of disposable EarPlanes good for one round-trip flight. Also great for mountain driving. Noise Reduction Rating: 20 decibels when used as directed. The range of noise reduction ratings for existing hearing protectors is approximately 0 to 30. (Higher numbers denote greater effectiveness.)