Inner Ear Barotrauma

[SteveBF]

I dove one of my favorite lakes last weekend and all week long I've felt like I had water in my ears, my hearing is kind of muffled and my ears pop when I swallow. I was thinking maybe I was getting an ear infection or something so before it got out of control and started hurting I decided to go to the doc and have hime take a look and see what was going on.

As it turns out my ears were not infected or anything but rather I have bleeding in the inner ear. The doc said it was a result of not equalizing properly. My max depth that day was only 73' and I was equalizing as I felt pressure building in my ears and never felt any pain. I was told this will resolve itself in a week or so. I'm closing in on my 100th dive so I'm not exactly new to diving and this has never happened before so it making me question whether I'm equalizing often enough... I've alway equalized when I feel pressure... should I be equalizing before I feel anything. This ear thing doesn't hurt or anything and is just mildly annoying but I don't want it to happen agian.

Cheers!
Steve

 

[TSandM]

I just want to write a little bit here about ear anatomy, because it seems probable that either you or your doctor have got things a bit mixed up.

The ear is divided into three sections: The outer ear, which is the pinna (the part you can see on the outside of the head) and the external auditory canal (the passage). The middle ear begins with the eardrum and includes the ossicles, or the small bones that transmit the sound energy to the structures of the INNER ear, which transduce it into nerve signals that the brain interprets as sound. The inner ear also includes the semicircular canals that give you balance information.

Most barotrauma, thank goodness, is damage to the MIDDLE ear, with the mild vacuum that occurs as a result of delayed or inadequate equalization causing fluid to ooze out of the tissues surrounding the air space, or even causing capillaries to rupture and cause some bleeding. This damage results in muffled hearing, crackling or popping sounds, and discomfort. It resolves over a variable period of time, depending on how severe the problem is.

Damage to the INNER ear results in significant hearing loss and often vertigo as well. This is serious stuff, because inner ear damage can be permanent.

In my experience, it doesn't take very long to get middle ear barotrauma -- just getting distracted by something and dropping for a few seconds without equalizing can result in some edema. On the other hand, damage to the inner ear is more commonly associated with severe problems equalizing -- the people who write that they made multiple, forceful efforts, or had severe ear pain in the process.

I think the message to you is that you may be waiting for too much of a discomfort signal to do your equalization. Starting by "pre-pressurizing" your ears, and then equalizing every few feet on descent, whether you feel like you need to or not, will help avoid this in the future.

 

[SteveBF]

I was hoping you or Tracy would reply... thanks for the clarification, I'm sure it's middle ear as he said it was behind the ear drum. I will definitly heed your advise and not wait for discomfort before equalizing... this isn't at all painful but it's definitly annoying!

 

[DandyDon]

Equalize early & often. The greatest changes in pressure happen at shallow depths. Some divers have to equalize on the boat a few times, then several times on the first 20 feet.

 

[iamjblevine]

... I've alway equalized when I feel pressure... should I be equalizing before I feel anything. This ear thing doesn't hurt or anything and is just mildly annoying but I don't want it to happen agian.

Equalize early and often. If you already feel the pressure you are equalizing too late. I will equalize on the surface and then every five feet of descent for the first 30' whether I feel any pressure or not. If I feel pressure I know I should be doing it more often and even sooner. Equalizing more often in the first 15' to 30' is easily overlooked.

 

[doctormike]

Late to the party, but here's my sticky! http://www.rothschilddesign.com/ear_scuba/

What TSandM said.

The terminology mixup is very common. Almost every time someone mentions an "inner ear problem", they actually mean middle ear. The devil is in the details!