blocked ears

[nickjb]

My friend is interested in starting diving. I took her to my club for a try dive and she could equalize one ear. Apparently she has had trouble before with blocked ears and has had then syringed a few times in the past. When she went to the doctor to get this done again he said that syringing ears could lead to permanent damage and he didn't want to do it.

He suggested that olive oil could help but this has had little effect so far.

Does anyone out there know of the issues with syringing or can anyone suggest a solution?

Thanks

 

[jbd]

is a common way of removing excess wax from the ear canal. There are also commercial preparations that do the same thing.

Since your friend seems to have a have a history of this it would proably be best to have an ENT doctor clean the ears out and the your friend needs to follow a prevention protocol

 

[John Reinertson]

There are a lot of past discussions on ears and diving. Review is good, as it is so common that all divers should have some understanding of it.

Ear problems can arise in the external canal, with wax or debris or skin flakes or infection blocking the canal. This often leads to an external otitis or swimmer's ear, and cleaning the debris from the canal is important to getting better.

This type of block does not cause pain on descent or difficulty equalizing..

Pain on descent or difficulty equalizing is caused by failure to get air from the nasopharynx through the eustachian tube to the middle ear. ( non-medical terms-- air doesn't get from the air cavity in the back part of the nose, that is filled with air at ambient pressure, to the middle ear cavity, which is a sealed air-filled space on the other side of the eardrum. The middle ear has to get its correction for external pressure from the eustachian tube, which connects the back of the nose to the middle ear. This tube is normally closed and opens with yawning, wiggling the jaw, or the other equalizing maneuvers we do.)

Olive oil and suction and syringing and ear drops can't get to the middle ear.. It is sealed and open only to the eustachian tube.

Scubadoc has an excellent website with detailed explanations and a review of equalizing.

The first step for your friend is to find out precisely what is going on with the block sensation, as the treatments are widely different.

If it's external ear blockage, there are many techniques to clear this and they often vary by locale as to which is preferred.

Olive oil is good. In the US they sell products such as debrox and cerumenex in all drugstores and they work ok.

Sometimes nothing works except removal in a doctor's office.

Having difficulty one time does not preclude learning to dive. Probably half or more of divers had to put some effort into learning to equalize and occasionally have minor problems with it when diving. Learning and perseverance works in most cases.


John

 

[Wordmonger]

I have a long, ugly history of ear infections from childhood on. Plus, the anatomy of my ears is such that they tend to hold water once it gets in there and it can take literally hours for them to drain. I've been to ENTs and had a long consult with an ENT who is also a diver, and he figured out the anatomy issue and provided some insight as to what to do. But the thing that has saved me is the ProEar 2000 mask. It actually protects the ears, so that the water (or at least just a teeny tiny bit of water) cannot get in there. For me, no water in the ears erases all the other problems associated with water in my ears, and it's the difference between torture and a successful dive. No, I don't work for the company. And I don't know anybody else who has ever used the product -- I found the product on the Internet after a weekend of diving that left me absolutely miserable and I was willing to try anything. The mask worked. Does it look strange? Absolutely. Do I care? Absolutely not. It's the only thing that has kept my ears healthy and me diving. There's a website: www.proear2000.com. (I actually discovered the product from some posts on the board here somewhere. I should say I tried it in spite of that. The posts are pretty strange -- mostly from people who either work for the company or who have never tried it or who have nothing better to do than make adolescent comments about the anatomy of the model. So take all that with a grain of sea salt. I've tried it. It works for me. And I'm buying another mask as backup because without it, I simply could not dive.)

 

[The Iceni]

Hi Nick,

Middle ear equalisation is a very common minor problem, which will almost always resolve with improved technique and practice. I am sure there are many other posts on this subject on this and other fora. It has nothing, whatsoever to do with wax or problems with the external ear canal, such as swimmer's ear.

John R has provided a very good explanation of the differences between the problems of the external ear canal and the middle ear but may I suggest you also take a look at the nieghbouring thread, to which I have also replied?

http://www.scubaboard.com/t13081/s.html

While the Pro Ear mask will keep the external canal relatively dry and has obviously helped wordmonger's problems I am not sure it can do what it's manaufacturers claim with respect to equalisation because it does not bypass the eustachian tube, the only connection between the middle ear and external pressure.

I think it is being advertised as solving the wrong problem.

It may well help with clearing the ears but I fail to see how it can.(and I am a tad past adolescence, wordmonger!)

 

[dandan]

Does this proear 2000 mask have any impact on equalization in anyway?

 

[The Iceni]

dandan once bubbled...
Does this proear 2000 mask have any impact on equalization in anyway?

A good question, Dandan. Could I suggest you take a look at the following link? You should be able to work it out for yourself.

http://www.earaces.com/anatomy.htm

You can see that the ear drum completely seals the external ear canal from the middle ear. The only connection between the middle ear and the outside is via the eustachian tube, which in life is much narrower than shown. If the lining is inflamed, for whatever reason, it becomes obstructed so fluid and bacterial debris are unable to drain from the middle ear, or pressures equalise. Unlike most animals, because of its large size, the human brain "squashes" the mid skull so there is less space for structures such as the eustachian tube which is consequently narrower.

Many children suffer from recurrent middle ear infections because their eustachian tube is so easily blocked. If left untreated these recurring infections can lead to deafness due to "glue ear".

Swimmer's ear and wax are problems restricted to the outer canal alone and have nothing to do with the middle ear or "clearing" so I honestly fail to understand how olive oil, syringing or the ProEar 2000 can help with equalisation. This is not to denigrate the positive benefits on the outer canal described by Wordmonger.

It is important not to confuse the two!

What the ProEar actually does is to keep the external canal relatively dry and it equalises the pressure in the external ear canal with that in the nasal cavity (the mask). As this can be controlled I suppose it could possibly help with clearing but in my opinion good technique and slow, initial, descents do this much more simply and cheaply.

:doctor:

 

[dandan]

So desu ne (So I see)
Thanks for the detailed explanation..Dr Paul

 

[HMan]

To start out with I want to make it perfectly clear that I am one of the inventors of this mask and have been primarily responsible for its launch into the diving marketplace.

That being said, I want to share with all of you that to date, there has been no scientific study regarding the ProEar masks benefits with respect to middle ear equalization. None the less, and to me this has tremendous importance, in the 2 years since the mask has been on the market we have received literally hundreds of testimonials from divers (and many instructors) from around the world who swear by the mask and its ability to allow for easier equalization. Many of these unsolicited testimonials can be found on the ProEar website www.proear2000.com and many, many more are in our files.

Perhaps it has to do with the difference between equalizing againt air as opposed to water on the ear drum, perhaps the constant exhalation via the nose (and into the earcups) on descent helps inflate the Eustachian tube, perhaps the dry air on the ear drum makes for less irritation and possible inflamation of the middle ear, we just don't know but one thing for certain there are over 10,000 satisified customers and many claim that it has saved their diving careers. We also hear from divers who say it has allowed them to return to diving having previously given up the sport they love specifically due to ear related problems.

If you have a chronic equalization problem, the first thing to do is to be checked out by a qualified ENT specialist, preferrably one with a background diving. This is a serious matter and you must consult a specialist. If after your consultation and examination, nothing is found that forbids you to dive then you owe it to yoursefl to try the ProEar mask. It just may be what you need to make your dives more pleasurable and comfortable.

 

[The Iceni]

HMan once bubbled...
. . . in the 2 years since the mask has been on the market we have received literally hundreds of testimonials from divers . . who swear by the mask and its ability to allow for easier equalization.

Hi Hman,

So what is the mechanism?

Looking at the anatomy of the ear and the mechanism employed by the mask can I make a suggestion?

If a diver attempts clear his ears forcibly, the increased pressure within the nasopharynx is transmitted to to middle ear and thence via the tympanic membrane (TM) to the external environment distorting the TM. This stretching limits the effectiveness of this manoeuvre in raising middle ear pressure because of the pain experienced when it is distorted outwards beyond its anatomically normal position. The manoeuvre is thus abandoned prematurely before suficient gas is injected into the middle ear to raise it's internal pressure above that required to overcome tissue elasticity and the diver is back where he started.

It would seem that if the ProEar does indeed transmit the (consciously) raised pressure within the nasopharynx to the outside of the TM, when wearing the mask there may possibly be less distortion of the TM by any such manoeuvre.

It would seem to me that this may allow the diver actively to increase the pressure within the middle ear, well above what would otherwise cause pain, and beyond that required to increase middle ear pressure above the tissue elasticity threshold, thus facilitating "clearing".

Far fetched? maybe, but perhaps this why it helps?