Ear pains just won't go away!

[frankc420]

This may be the wrong part of the board to post on, but, I couldn't find anywhere else by glancing through.

Just about everytime I dive, I end up with swimmers ear. Well, a month ago I went diving and obviously came back home with an infection, this time though, my hearing was muffled, so I went to the ENT. He said I had an infection in my inner canal and to use some medicated ear drops he prescribed, it says on the front "NEOMYCIN AND POLYMYXIN B SULFATES AND HYDROCORTISONE OTIC SUSPENSION, USP." Well, this simply removed the muffled and some of the pain, but now, if the wind blows on my ear, I get a sharp pain. The ENT wants to blame the lingering pain on TMJ, but TMJ wouldn't cause my ears to sound like something is in them when I do the "hold nose and blow" test. When my ears start to fill with air, the little 1 pop you get when they expand, I get 4-5 in the infected ear.

No oral antibiotics have been prescribed, so if it's middle ear, I'm sure that would help, but the ENT refuses to give me orals since he thinks it's TMJ.

Any suggestions are appreciated! I'm wanting to go diving in January and want this junk GONE! I've recently mixed me a batch of 50/50 rubbing alcohol/vinager, so maybe that will keep me out of this next time around!

 

[fisherdvm]

I don't understand the 1 to 4-5 pop. Please explain.

I would suggest drying your ears after each shower or after diving with a thin wisp, or strand of kleenex tissue. It is too thin and soft to impact the wax and would not injure your ear drum. It is highly effective in drying out your ear.

If you have otitis externa, I prefer an otic with antifungal activity also, such as cortain B aquous, and my preference is to use any steroid drops only on 3 consecutive days a week.

The rubbing alcohol/vinegar mix is a good drying and acidic solution to dissolve ear wax, but you have to be careful that you don't have a ruptured ear drum, as it can cause damage to the inner ear.

No doctors are perfect, you might want to get a second opinion from another ENT.

 

[shark.byte.usa]

I've had similar ear problems recently. For swimmer's ear, the antibiotic drops seem to do the trick. The one time I got a bad ear infection, I was precscribed both oral and drop antibiotics, I was diving 11 days later (about 4 days after symptoms were all gone).

I dry me ears after a dive with OTC alcohol drops, some say it's bad, but it seems to be what works best for me, I've tried varying solutions.

Get a second opinion; especially if problems/infection lingers. My .02 psi

-Garrett

 

[fisherdvm]

Since time and cost is a factor, a shotgun approach my be a good solution prior to getting any expensive treatment and dental appliances for TMJ.

I would suggest - after a good otoscopic and tympanometric exam - considering a trial of decongestant, antihistamine, and possible use of an oral antibiotic (if evidence of fluid or inflammation noted in the inner ear).

Of course, if your wife is a major stressor, going on a vacation by yourself might be enough to relieve the stress, and cure the TMJ ....

 

[TSandM]

A sharp pain on exposure to cold air is almost certainly not a symptom of a persistent middle ear infection. Those are constantly painful. Serious otitis, with persistent fluid in the middle ear, results in muffled sound on the affected side.

The drops you were given are treatment for infection of the external ear canal. Drying agents containing alcohol are often effective in preventing this problem.

The popping sound you're hearing may be indicative of some remaining middle ear edema fluid, or an anatomic or functional Eustachian tube problem on that side.

If you're not confident with the diagnosis the ENT physician has made, I would suggest you seek a second opinion. You're unlikely to get any useful specific information from the internet, as we are unable to examine your ear.

 

[snorkelcorey]

" If I was in frankc420's place, I would get 'another oppion' from another Nose, Ear and throat Speciallist. I have a question for any one who has a Medical, that speciallizes in Diving Medicine. Almost 2 years ago, I had Tubes put in my ears. and I asked the The Doctor who put the Tubes in my ears if I could Scuba Dive, after geting Tubes put in my ears. And She said no, that I can't dive because of the tubes being in my ears. I asked Ber Rabbit who's on staff here on scubaboard, about what would happen if I did try Scuba, just to see what it's like, even though I have Tubes in my ears. Is there any here on scubaboard who has a Degree in Diving Medicine who can answer this question? I would really appreciate a reply regarding my question. Snorkel Corey

 

[fisherdvm]

The inner ears are essentially sterile.... Actually, not completely. As long as serous fluid carrying white blood cells and antibodies are continously draining through the inner ear and the eustachian tube, you are free from ear infections.

However, when the eustachian tubes are plugged, serum accumulates, and bacteria start to colonize the inner ear causing infection. The pus accumulates and causes pain, fever, and damages the structures of the inner ear - causing hearing loss.

That's why the little PE tubes are inserted. They are little tubes that perforate the ear drums. They are windows that allow the fluid to drain to the outer ears, when the eustachian tubes are obstructed. If God is willing, the eustachian tubes reopens, and the PE tubes falls out into the external ear. Within a short time, the little slit where the PE tubes are placed in will seal.

As long as the PE tubes are still in your ear drums, you essentially have a "ruptured" ear drum. You can not dive, as water will enter the inner ear. This water is dirty, containing many pathogens - and can cause serious ear infection.

Once the etiology of your frequent ear infection is cleared, once your PE tubes have fallen out, and once your ear drums are sealed...... Technically, you could dive again.

However, your eustachian tubes might be scarred, and still not working well. Diving with such a malfunctioning eustachian tube might put you at risk for injury to the inner ear - the round or oval window. Rupture of this might cause permanent hearing loss.

I agree with your ENT doctor - you should not dive. Not until repeated objective testing reveal your ear drums intact and sealed, and your eustachian tubes functioning.

 

[frankc420]

As for what am I talking about on the popping, well, it's like there is liquid, a thick liquid, in my middle ear (probably puss) that causes it to make a funky sound 4-5 times. Maybe it's creating small bubbles that pop and that's what I'm hearing? I'm not sure.

I'm going to get another opinion. The first time all of this started, I had dizzy spells. I've since had the pressure tests done and do not have a ruptured ear drum. Probably just an infection that the current ENT can't find.

Thanks for your replies!

 

[fisherdvm]

Sounds like a complicated case. A physician might just treat it conservatively with oral antibiotic, decongestants, and antihistamines.

But if you are a regular diver, and the symptoms are related to a recent dive, more diagnostics might be needed to make sure you don't have rupture of the oval or round window. I am not an ENT, and you should ask your ENT if injury of the inner ear might have cause the fluid accumulation.

To call your symptoms TMJ is absurd.... However, you might not have told your ENT all you have told us here.

 

[DocVikingo]

Hi fisherdvm,

You state: "The inner ears are essentially sterile.... Actually, not completely. As long as serous fluid carrying white blood cells and antibodies are continously draining through the inner ear and the eustachian tube, you are free from ear infections.

However, when the eustachian tubes are plugged, serum accumulates, and bacteria start to colonize the inner ear causing infection. The pus accumulates and causes pain, fever, and damages the structures of the inner ear - causing hearing loss."

Do you in fact mean middle rather inner ear or I am missing something?

http://www.ear-anatomy.com/images/ear diagram 2_producer.gif

Thanks,

DocVikingo