Okidiver1369
New
Hello, thanks for letting me join your chat, first let me say that I’m really impressed with how giving folks are with their time and expertise in answering and following along with questions. I’ve learned a lot through other’s experiences. We are in the middle of a pretty respectable Typhoon here in Okinawa Japan so I have a little bit of time to write this before my computer runs out of juice; sorry this is so long!
BLUF: Had a small ear issue scuba diving that turned into a bigger issue a couple of days later when spearfishing. The ear injury has reduced hearing in my right ear in the higher frequency’s and is the second ear issue I’ve had in that ear. This is after I’ve had a less impactful ear issue in the same a couple of years before. I am seeking diver informed opinions on what might have happened, those that have had similar experiences, and any other possible treatment options I should consider with the ENT.
Background: 41-year-old male with just shy of 50 scuba dives. In the military so decent health, scuba dive and spearfish at least every other weekend (I live in Okinawa Japan so why not?).
Diving medical history:
*Note: Sometimes have a hard time equalizing so Valsalva maneuver that sometime causes a squeal like a small animal getting murdered underwater. I frequently do it pretty hard without any previous issues (Didn’t realize you can get messed up doing, my mistake)
*2021, Apr-Initial ear injury while snorkeling in ’15 ft. Tried swallowing and popping ears to equalize w/o Valsalva maneuver. Sudden deflating feeling in ear followed by mild tinnitus and muffled hearing. No pain. Visited general medical doctor whom does not observe any visible damage inside the ear. Get appointment with ENT for 3 months later. The doctor theorizes sudden depressurizing of ear which causes impact to cochlear and subsequent damage to the ear nerves resulting in slight neurosensory hearing loss. Advised not to dive for 3 months, which I follow.
*2023
-20 July: Have chest congestion with productive cough but nothing in the sinuses (not smart to dive). Day dive (114’), Night Dive (69’), Slight trouble equalizing slight issues clearing, soft muffled hearing in right ear, don’t think much of it.
-22 July: Have chest congestion with productive cough. Spearfishing to ’18 ft, extreme forced Valsalva maneuver to right side to clear. No issues with dive until after returning to shore: 1) had a bit of what felt like lightheadedness’s and feeling slightly off, 2) Louder more erratic tinnitus, 3) Muffled hearing, frayed in higher frequencies noticeable when a baby crys or when I talk louder, muffled when sorting through ice or crinkling plastic bag
-25 July: Pure tone hearing test shows hearing loss in 3000 and up frequencies (results attached and below). General medical doctor refers me to a ENT. Notes that he sees fluid in the ear, tuning fork test heard in bad ear. *This is later contradicted by ENT whom does not see fluid in the ear the following day.
-26 July: ENT appointment: Dr. checks out ear and doesn’t observe fluid or trauma in ear, eustachian tubes functional. Theorizes that I have an enlarged vestibular aqueduct (EVA) worsened by mild barotrauma. Believes this because this is my second issue and mother had SSHL when she was a child so may be genetically predisposed for hearing issues. Prescribes 14-day prednisone taper. CT scan taken, awaiting results from radiology.
-28 July: Pure tone hearing test from administered by military audio technician show improvement in hearing in mid-level frequency’s and very slight improvement ~5 in higher frequencies (results below).
*First test taken with an audiologist. Second taken with audio tech, third taken with audio tech and while taking prednisone.
-2 Aug: Currently, taking prednisone and working out (run, bike, surface swim, crossfit type workouts). Slight feeling of being off in the morning with something like very minimal light headiness; balance is fine and no spinning or even dizziness.
Future:
-4 or 7 Aug: Plan to get another pure tone hearing exam with audio technician for in stride assessment, (If this typhoon lets up)
-8 Aug: Last day of 14-day prednisone taper
-14 Aug: Scheduled Audiogram with Audiologist (first appointment available) for audiometery, pure tone, speech test, etc.
~16 Aug: ENT follow up appointment to review audiogram eval and CT scan of effected ear for EVA.
Concerns:
Charlie
BLUF: Had a small ear issue scuba diving that turned into a bigger issue a couple of days later when spearfishing. The ear injury has reduced hearing in my right ear in the higher frequency’s and is the second ear issue I’ve had in that ear. This is after I’ve had a less impactful ear issue in the same a couple of years before. I am seeking diver informed opinions on what might have happened, those that have had similar experiences, and any other possible treatment options I should consider with the ENT.
Background: 41-year-old male with just shy of 50 scuba dives. In the military so decent health, scuba dive and spearfish at least every other weekend (I live in Okinawa Japan so why not?).
Diving medical history:
*Note: Sometimes have a hard time equalizing so Valsalva maneuver that sometime causes a squeal like a small animal getting murdered underwater. I frequently do it pretty hard without any previous issues (Didn’t realize you can get messed up doing, my mistake)
*2021, Apr-Initial ear injury while snorkeling in ’15 ft. Tried swallowing and popping ears to equalize w/o Valsalva maneuver. Sudden deflating feeling in ear followed by mild tinnitus and muffled hearing. No pain. Visited general medical doctor whom does not observe any visible damage inside the ear. Get appointment with ENT for 3 months later. The doctor theorizes sudden depressurizing of ear which causes impact to cochlear and subsequent damage to the ear nerves resulting in slight neurosensory hearing loss. Advised not to dive for 3 months, which I follow.
*2023
-20 July: Have chest congestion with productive cough but nothing in the sinuses (not smart to dive). Day dive (114’), Night Dive (69’), Slight trouble equalizing slight issues clearing, soft muffled hearing in right ear, don’t think much of it.
-22 July: Have chest congestion with productive cough. Spearfishing to ’18 ft, extreme forced Valsalva maneuver to right side to clear. No issues with dive until after returning to shore: 1) had a bit of what felt like lightheadedness’s and feeling slightly off, 2) Louder more erratic tinnitus, 3) Muffled hearing, frayed in higher frequencies noticeable when a baby crys or when I talk louder, muffled when sorting through ice or crinkling plastic bag
-25 July: Pure tone hearing test shows hearing loss in 3000 and up frequencies (results attached and below). General medical doctor refers me to a ENT. Notes that he sees fluid in the ear, tuning fork test heard in bad ear. *This is later contradicted by ENT whom does not see fluid in the ear the following day.
-26 July: ENT appointment: Dr. checks out ear and doesn’t observe fluid or trauma in ear, eustachian tubes functional. Theorizes that I have an enlarged vestibular aqueduct (EVA) worsened by mild barotrauma. Believes this because this is my second issue and mother had SSHL when she was a child so may be genetically predisposed for hearing issues. Prescribes 14-day prednisone taper. CT scan taken, awaiting results from radiology.
-28 July: Pure tone hearing test from administered by military audio technician show improvement in hearing in mid-level frequency’s and very slight improvement ~5 in higher frequencies (results below).
Date | Left | | Right | |||||||||
500 | 1000 | 2000 | 3000 | 4000 | 6000 | 500 | 1000 | 2000 | 3000 | 4000 | 6000 | |
10 Apr 23 | 15M | 15M | 20M | 35M | 35M | 35M | 10M | 15M | 10M | 20M | 55M | 55M |
25 Jul 23 | 10M | 10M | 15M | 30M | 35M | 20M | 10M | 5M | 15M | 55M | 80M | 85M |
28 Jul 23 | 10M | 5M | 0M | 25M | 25M | 35M | 10M | 0M | 5M | 30M | 75M | 80M |
-2 Aug: Currently, taking prednisone and working out (run, bike, surface swim, crossfit type workouts). Slight feeling of being off in the morning with something like very minimal light headiness; balance is fine and no spinning or even dizziness.
Future:
-4 or 7 Aug: Plan to get another pure tone hearing exam with audio technician for in stride assessment, (If this typhoon lets up)
-8 Aug: Last day of 14-day prednisone taper
-14 Aug: Scheduled Audiogram with Audiologist (first appointment available) for audiometery, pure tone, speech test, etc.
~16 Aug: ENT follow up appointment to review audiogram eval and CT scan of effected ear for EVA.
Concerns:
- I understand that the first two weeks to a month is when most gains happen with hearing loss based on my informal research into treatment methods/timelines. Luckly, I was able to get prednisone within 4-6 days after the initial issues. Should I push harder to get to a closer follow-on visit with the ENT for a tympanic steroid injection? In my simple math, more is better.
- Given that I really yarded away at Valsalva maneuver against a possible already irritated inner ear could I possibly have something like perilymph fistula? Should I be concerned with the very slight off feeling in the morning? Should I lay off the working out? My thoughts were that it gives more blood flow to the effected area to aid in healing but that’s my best guess and not based on medical advice.
- What next step should I advocate for if no significant change?
- Anyone been a similar situation? I will of course weigh risks based on follow on assessments. I would imagine that if there is improvement and no genetic or structural issues then 3 months off if I do return to underwater life. It seems that spearfishing and free diving have been a bit tougher on the ear than just diving.
Charlie