Treatment for middle ear barotrauma

[ScubaJW]

Hello...

I just went to the doctor last Friday. The doctor told me that I have barotrauma in my left ear (Eustachian tube dysfunction) or in other words, my Eustachian tube has collapsed. I also called DAN and they gave me the list of ENT doctors that I need to go to if it doesn't heal in about a week.

I also searched on Scubaboard for more information on treatment. There is not much out there except Sufaded and Nasnox (nasal spray). I need more information...

I know this is common among divers. What did you do to treat your barotrauma? How long did it takes to heal?

FYI: I only wanted to know the treatment and the length of time before it heals, so please don't talk other than my questions. If you have something else to say other than this, please PM me. Thanks.

Thanks for taking the time to respond to my questions!

 

[emcbride81]

I am not sure if what I had was similar to yours, but the pain stopped after about 4 days, but I had issues with sneezing and blowing my nose for almost 6 weeks.

 

[TSandM]

Middle ear barotrauma involves fluid exudation in to the middle ear, and possibly hemorrhage. There is no treatment but time.

 

[DocVikingo]

Hi ScubaJW,

In addition to fluid exudation into the middle ear, and possibly hemorrhage, as mentioned by TSandM, rupture of the eardrum also is considered middle ear barotrauma. However, you seem to have no evidence of this latter condition.

It appears that your middle ear space is congested, but a definitive diagnosis of "collapsed Eustachian tube" cannot be made by simple examination of the external ear. At the very least one would need to perform tympanometry, a procedure not done by the routine PCP. This, along with sonotubometry, would be performed by an ENT.

Assuming that infection requiring an antibiotic has been ruled out, as TSandM has said time is among the better treatments. However, there are therapies that can be tried, such as acetaminophen (e.g., Tylenol) or ibuprofen (e.g., Advil) for discomfort and application of a warm cloth or a hot water bottle to the area around the ear. Topical vasoconstrictors such as phenylephrine (e.g., Afrin, Neo-Synephrine; follow directions carefully when using these), nasal steroid sprays (e.g., Flonase, Nasonex) and oral decongestants such as pseudoephedrine (e.g., Sudafed) sometimes provide a bit of relief.

If the condition gets worse or lasts more than a week without obvious improvement, contact with an ENT is highly recommended.

In any event, return to scuba before all signs and symptoms have resolved, and the diver can equalize gently and regularly, would be unwise.

Please keep us posted on your situation.

Helpful?

This is educational only and does not constitute or imply a doctor-patient relationship. It is not medical advice to you or any other individual and should not be construed as such.

Regards,

DocVikingo

 

[ScubaJW]

Thanks DocVikingo, TSandM, and emc. My left ear hasn't show any obvious improvement yet but not as severe as most people. I will have it checked by ENT with diving knowledge after the particular time has passed.

 

[sarita75]

I have had issues with this on 2 occaissions - always the same ear. I called DAN about it and was told to take Sudafed and Advil. I did this both times and was able to resolve the matter within 5-7 days.

 

[scubapatton]

A buddy of mine just got diagnosed with the same thing. He actually had to wait ~7 days. There was NO medication that helped. He then tried his luck in a pool. He felt a little gun shy at first, but was OK. He went to the ocean 2 days later and had some issues with equalizing. He went to the doc the next day and was told he probably just needed a few more days. His doc was versed in diving medicine by the way.

He then waited a week and tried again, and viola... no issue.

My best thought would be to wait two full weeks, then try a pool session - even a shallow friends pool just skin diving if you can....

Good luck. It is good to hear people have these issues and then can still dive.. take comfort in that... it will heal.. you just have to go dry for a bit...

 

[ScubaJW]

My left ear shows an obvious sign of improvement. No more stuffed or uncomfortable as it has finally returned to normal. I will be going diving next weekend - finally!

Thanks yall.

 

[ScubaJW]

Thought I would keep you guys updated - this past weekend, I dove in Blue Grotto, went to ~100 ft with no problems!!!

 

[jddemtp]

I had no pain but had a "clogged" feeling that wouldn't go away for several days, so I made an ENT appointment. Eustacian tube dysfunction was the diagnosis. After a six day steroid taper and ten days of pseudoephedrine/guaifenesin, I was right as rain. Every so often I have to slow down to equalize, but otherwise have been ok since.