Some people can not Valsalva effectively enough to clear their ears, if at all.

Save your money. I don't think it is possible it could work. Something HAS to create pressure in the eustacian/behind the eardrum to equalize it. A device, especially one pushing $200, shouldn't be able to do it if a valsalva can't.

As I understand it, the positive pressure opens up your eustacian tubes while you swallow ... opening your tubes and draining the fluid.

Afrin, motrin, and valsalva to get down. Then see your doc to fix whatever got you in that situation in the first place.

While being unable to clear your ears can be uncomfortable, real pain comes from fluid trapped in the sinus cavities. This can come close to feeling like having a dull, rusty 1/4" drill bit run slowly into your face.
Flight surgeons have recommended a good blast of Afrin or three and sudafed in the past.

If you are having trouble clearing your ears it is best to stay out of aircraft with high cabin climb/descent rates or freefall jumping.

wrxsteve:

I have the same problem with you. If you tried this device, please tell me if it works. THX

A few years ago my sinuses finally got to the point to where they wouldn't clear on the way up and hurt the entire flight. I had Rotor Rooter surgery and have had no problem since. I highly recommend seeing a ENT doctor for an evaluation.

After a CAT scan my doctor was able to see polyups and inflammation that made air passage virtually impossible. He went in there and cleared out a lot of tissue and straightened out my deviated septum. The 2 week recovery was unpleasant but the results are pure joy. Blowing my nose now is productive. I can smell things again. I have no trouble with ear or sinus clearing.

See a doctor.

Afrin + Valsalva works wonders. I do this when I start to feel an ear infection coming on (spongy/sluggish valsalva). Opens the eustachian tubes and drains the gunk prior to a blockage taking effect.