Barotrauma left ear

[azlb11]

Just saw a PA about an issue i have while diving. I equalize fine but if I surface and go back down i tend to have issue equalizing on the repeat decent. If i stay out of the water a period of time and do my second dive no issues. Usually this happens if we surface to get a bearing and descend again; which doesnt happen often... Any ideas why?

Anyways she said i have a little blood behind the ear drum and ruled it barotrauma; i have no infection and barely any discomfort(if any) so on Friday i am going to see an ENT specialist and just curious how long i might be out of the water for if this turns out to be minor? Also, anything i can tell him to help speed up his diagnosis? I know a lot of this will depend on what he finds but rather gather some info before i see him.


I feel the barotrauma was due to the the issues with equalization i was having on the second decent and want to find the root of that problem as well. Also, no colds or sinus issues.

 

[TSandM]

I don't know what the diagnosis is, but my suspicion is that it's not equalizing fast enough or completely on the initial descent. I have exactly the same issue, but not always . . . but enough trips up and down in the water column will always do it to me, and like you, if I get out of the water for an hour or so, it resolves. I think it's mild edema due to repeated mild trauma. I have had to cut pool sessions with students short because I got to where I just couldn't descend again, but I've been fine to dive the next day, with no muffled hearing, no crackling, no problems equalizing.

 

[azlb11]

Thanks for the speedy reply and the insight. Hopefully the prognosis is good for me on Friday and I can dive this weekend with a student; hate cancelling but obviously "stuff" happens.

 

[flots am]

Just saw a PA about an issue i have while diving. I equalize fine but if I surface and go back down i tend to have issue equalizing on the repeat decent. If i stay out of the water a period of time and do my second dive no issues. Usually this happens if we surface to get a bearing and descend again; which doesnt happen often... Any ideas why?

Actually, I might. If you have a distorted bite (teeth don't match evenly on both sides) or a hose that isn't positioned properly and twists the mouthpiece, biting your mouthpiece gives uneven pressure on both sides of your jaw and can annoy your eustation tube, making one side close up. I have this, and my ENT recommended switching to a custom-moulded mouthpiece like a sea-cure, which has helped quite a bit.

Also, if I bite too hard, I only get a few up/down cycles no matter what mouthpiece I use. Keeping my jaw relaxed helps quite a bit.

I have no idea how they're actually connected, but that's what he said, and recommended and it worked.

Your Mileage May Vary.

flots.

 

[azlb11]

Actually, I might. If you have a distorted bite (teeth don't match evenly on both sides) or a hose that isn't positioned properly and twists the mouthpiece, biting your mouthpiece gives uneven pressure on both sides of your jaw and can annoy your eustation tube, making one side close up. I have this, and my ENT recommended switching to a custom-moulded mouthpiece like a sea-cure, which has helped quite a bit.

Also, if I bite too hard, I only get a few up/down cycles no matter what mouthpiece I use. Keeping my jaw relaxed helps quite a bit.

I have no idea how they're actually connected, but that's what he said, and recommended and it worked.

Your Mileage May Vary.

flots.

Interesting you mention that. i do have a cross bite, guess that would be the word for it, and over the years it's shifted a bit. Going to mention this to him on friday.

 

[Couv]

+1 to Flots

Some people tend to chew with one side of their jaw. If you're finding that one ear tends to clear much easier than the other give both sides of your bite a chance to share the workload of eating.

Some of my students found that a stretching exercise before and between dives helped in clearing a "difficult ear" while diving. Try to rest your head on your shoulder (not possible for most) on the opposite side you're having difficulty-hold it there for 15-20 seconds. Repeat until someone starts making comments.

Couv

 

[flots am]

Can any docs around here that can explain how jaw alignment or stress effects the eustation tubes?

My ENT mentioned it, and reducing jaw stress and alignment problems definitely reduces equalization problems, but I have no idea how.

flots.

 

[Duke Dive Medicine]

flots,

The Eustachian tubes connect the middle ears to the nasopharynx, which is the area of the throat behind the sinuses. Moving the jaw around moves that part of the pharynx and can help open the Eustachian tubes, and clenching the jaw can flex the surrounding muscles and possibly narrow the openings of the tubes in the nasopharynx. The tubes themselves travel through bone as they exit the middle ear, then fleshy cartilage as they get closer to the nasopharynx. This makes it easy for air to exit the middle ear but not so easy for it to enter, which is why divers rarely have to actively equalize their ears on ascent but may have difficulty on descent. Because of their proximity to the throat and sinuses, the fleshy openings of the tubes are vulnerable to upper respiratory infections, allergies, and other irritants like salt water. The tubes can easily become inflamed and swollen, which can make it difficult for air to pass through them and into the middle ear.

 

[flots am]

The Eustachian tubes connect the middle ears to the nasopharynx, which is the area of the throat behind the sinuses. Moving the jaw around moves that part of the pharynx and can help open the Eustachian tubes, and clenching the jaw can flex the surrounding muscles and possibly narrow the openings of the tubes in the nasopharynx. The tubes themselves travel through bone as they exit the middle ear, then fleshy cartilage as they get closer to the nasopharynx. This makes it easy for air to exit the middle ear but not so easy for it to enter, which is why divers rarely have to actively equalize their ears on ascent but may have difficulty on descent. Because of their proximity to the throat and sinuses, the fleshy openings of the tubes are vulnerable to upper respiratory infections, allergies, and other irritants like salt water. The tubes can easily become inflamed and swollen, which can make it difficult for air to pass through them and into the middle ear.

Thanks! I knew what my ENT told me was working nicely, I just never knew "why"

flots.