Perferated Ear Drum

[mempilot]

I perferated my left drum at 90' off Grand Cayman on Oct. 17th. I saw a doctor there who diagnosed the problem. I have completed an antibiotic regiment and have stayed topside to date. I saw an Ear, Nose, and Throat doctor today. He is also a diver. He stated that my perf was healed, but had to pull a hard wax ball out that was against the drum. He believes that pressure built up and forced the hard wax against the drum. The first Dr. didn't clear the wax since it was painful back then. He ran hearing, equalization, and inner ear fluid tests and stated that all was fine.

Here's the problem. He recommends that I not dive anymore! Whooaaa!! If I can equalize and the small perf (pin head) is healed, what's the problem? I understand the perf is scarred over and isn't as strong as original tissue, but don't people start diving after these incidents within a month or two? I don't shy away from calculated risks that I deam acceptable. I'm a pilot by trade and and feal the effects of pressure changes between .5 ATA and 1 ATA at a rate of 500fpm all the time. That would be like dropping from the surface to 16' in a hurry which I don't do. I plan my descents/ascents based on tables and back them off for squeeze problems.

I normally don't have problems equalizing. That day I did due to some lingering congestion. I can keep clear of diving on those days, but not all together.

Thoughts?

 

[Bob3]

In the end its your call. Having a perforation "leak" isn't a life threatening event, though a rupture can send ya "spinning" 'till the water in the middle ear warms up.
If losing some of your hearing is an issue, I'll introduce you to my ex, you'll be praying to go deaf after brief while. :tease:

 

[mempilot]

I just got rid of a noise machine myself. I experienced the vertigo for about 10 seconds on the first perf. I used to dealing with weather induced vertigo in the airplanes, so it didn't bother me all that much. I just didn't like having to sit out all these weeks while the hole sealed up. I didn't lose any hearing, knock on wood. I'm going to try some shallow reef buddy dives this week.

 

[beche de mer]

mempilot once bubbled...

Here's the problem. He recommends that I not dive anymore! Whooaaa!! If I can equalize and the small perf (pin head) is healed, what's the problem?
Thoughts?

An uncomplicated barotraumatic perforation should not prevent you diving. They usually heal up in 1 or 2 months.

Are you sure there wasn't associated inner ear barotrauma or some other complication?

Some physicians would carry out serial audiograms to exlude other conditions. If the perforation is now healed, your hearing should be just about back to normal. If you still have a signficant hearing loss, there may be complications.

I'd suggest you speak to your ENT man and ask why you should be beached. Maybe he was concerned that you might be jeapardising your profession.

It might be a bit early to try some shallow reef dives. Most barotrauma occurs within a few feet of the surface.

 

[beche de mer]

beche de mer once bubbled...


An uncomplicated barotraumatic perforation should not prevent you diving. .

err, I meant they shouldn't prevent from resuming diving once they've healed.

 

[mempilot]

He ran the audio tests. All indications were that my hearing was fine. He said the eustacian tube was clear and working. He cleaned the wax out of the ears and said the perf had healed. He said 'officially' I shouldn't dive, but 'unofficially' I should be fine. I'm a pilot and a perfectionist. I like definitive answers. There are no officially and unofficitally in flying, and there shouldn't be in diving either.

The reason for the shallow dives is this. I understand that pressure doubles from the surface to 33' and then doubles again at 99'. The perf happened at 93 fsw about 25' from the end of a downward sloping chute that emptied on a 3000' drop to the ocean bottom. Not a fun place to experience 12 seconds of vertigo. I'm a calm person, so I just held on for the ride. At 33 fsw, if I experience severe vertigo, the surface is in sight, no deco, and an exit strategy exists. Good depth to test. I'm actually testing it in a 12' pool this afternoon. Hope it works.

 

[GoBlue!]

mempilot once bubbled...
He ran the audio tests. All indications were that my hearing was fine. He said the eustacian tube was clear and working. He cleaned the wax out of the ears and said the perf had healed. He said 'officially' I shouldn't dive, but 'unofficially' I should be fine. I'm a pilot and a perfectionist. I like definitive answers. There are no officially and unofficitally in flying, and there shouldn't be in diving either.

The only way to be 100% sure you don't perforate your eardrum diving again is to not dive. Unfortunately, I doubt there are many good studies of the probability of perforating an eardrum a second time after a 1st injury. These would be fraught with confounders (i.e., an eardrum that perfs due to poor diving technique in an uneducated diver may have a different rate of reinjury as an eardrum that perfs due to an anatomic abnormality of some sort). So, your doc probably has no way of telling you whether you should or shouldn't give up diving. If you think that the eardrum perforated because you had a cold that day & you didn't equalize well, then once it heals in a couple month's time, you should be fine.

Anecdotally, my wife was never taught the importance of clearing early & often. Sure enough, after a few years, she perforated her eardrum. We met & started diving together, and she was amazed at how painless diving was. Needless to say, she's dove for several years now after her incident, and no repeat injury with her much improved technique!

Jim

 

[beche de mer]

mempilot once bubbled...
He said 'officially' I shouldn't dive, but 'unofficially' I should be fine.

Now I think I understand. Unofficially he gave you the OK but officially he wasn't prepared to put his signature to it.

My guess is that he was concerned about the small but finite risk that you might suffer a further perforation, develop a chronic perforation with hearing loss, could no longer meet the medical critieria for a commercial pilot's rating, lost your job, and then came after him with your attorney.

 

[mempilot]

beche de mer once bubbled...


Now I think I understand. Unofficially he gave you the OK but officially he wasn't prepared to put his signature to it.

My guess is that he was concerned about the small but finite risk that you might suffer a further perforation, develop a chronic perforation with hearing loss, could no longer meet the medical critieria for a commercial pilot's rating, lost your job, and then came after him with your attorney.

I think your right. I checked with DAN, and they state that many return to diving after a mild baratrauma to the membrane. Since the first 12 feet or so tend to be the hardest on the ear if you aren't equalizing, I went to the pool the other day. It worked fine. I doing a dive this morning, slow and deliberate. We'll see how it does. My buddy is aware and ready to help the event of vertigo.

 

[MikeBattie]

I think your right. I checked with DAN, and they state that many return to diving after a mild baratrauma to the membrane. Since the first 12 feet or so tend to be the hardest on the ear if you aren't equalizing, I went to the pool the other day. It worked fine. I doing a dive this morning, slow and deliberate. We'll see how it does. My buddy is aware and ready to help the event of vertigo.

Hi, I'm interested to know if your still diving after your ear perf. I perfed my left ear last summer in the Bahamas even after 10 years of diving in predominatly challenging conditions! all my own fault tho. I was booked on a weeks liveabord diving in teh Red Sea with my dive club but have just been to see a ENT cons who has told me too not to dive ever again - i'm really devasted.

My hearing is fine, but the ear drum gives more than it should when pressure tested. I havent dived since last summer when it happened and will leave diving alone until spring 2006. My ENT cons will test the ear again in 12 months to whether it is improved.

I can equalise the ear fine and I have never had problems in the past.

Would be really grateful if you could let me know how you are now - scuba diving is a big part of my life and I hope it still will be!

Thanks Mike