Diving after perforated eardrum

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Scuba John

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Location
Phuket, Thailand
# of dives
I'm a Fish!
Hi all. I hope this is the correct place to ask my question. I just recovered from a perforated eardrum incident. The hole has closed and my doctor (who is not a diving physician) tells me to "keep it dry" for another two weeks before I swim or get water in it. I would like to know how long I should wait before I scuba dive?

Background. On or around Nov 8, 2020, my ear started feeling funny. It didn't hurt but sometimes there was a sharp pain above my neck but it did not feel like a normal ear infection. When my hearing started to diminish a week later, I went to a clinic here in Phuket, the doctor flushed it with warm water but couldn't really get a good look at it. There clearly was infection so he gave me a course of antibiotics and after a week, cleaned it again. In that examination he found a pin-hole perforation in my ear which surprised the heck out of me. 45 years of diving and I've never had this happen before and for the record, I had not been diving (due to Covid restrictions) since Feb 26, 2020. So this happened without diving, maybe when I was playing with clearing my ears as we divers do? I have no idea.

By this time the infection had moved to my chest, so he gives me anti-viral meds. A week later it has moved back into my inner ear again, so he gives me another round of antibiotics. A week later it's not better so he sends me off to a specialist, where I should have gone to begin with. But with no pain at all, really, just diminished hearing, I didn't think it was a big deal. We've all had ear infections and most of the time they are no big deal.

I go to my regular ENT at the hospital here, and he looks in with a scope so I can see the perforation. Clearly there is infection so he gives me another round of antibiotics. The hole is only a pin-hole, very small, but when I equalize we can see fluid coming through the hole. A week later the infection has not cleared and the hole has not closed so he takes a culture and takes another guess at antibiotics. A week later the culture says I have a bacterial infection. There is no longer liquid coming out, only air. Luckily he guessed correctly at the type of antibiotic to use and he gave me another week of it, both oral and ear drops. Two weeks later I go back (yesterday) and the infection has cleared and the hole has closed. Yay.

Thanks all.
 
I'm sorry to hear about your experience. I'm not a physician, so I can only tell you my experience. I also experienced a perforated ear drum a few years ago, the result of an upper respiratory infection. I did a lot of reading, which suggested that minor perforations will heal on their own within 4-12 weeks (a fairly big window). I saw an ENT a couple of weeks after the injury, and he was unable to see a perforation at that point. I dove again 7 weeks after the incident and I had no problems at all. That put me at least 5 weeks out from when the perforation closed. I really have no idea if my experience is typical of small perforation injuries. I was actually quite worried about the 5 week time frame, but fortunately it turned out OK. I think if I experience this again, I'll probably give myself 6+ weeks before getting back in the water. Good luck with it!
 
Two weeks later I go back (yesterday) and the infection has cleared and the hole has closed. Yay.

Glad to hear that you're ear has healed. Coincidentally my first perforation was diving off Phuket back in the 80s.

Stay out of the water for four more weeks and make sure it's well and truly healed before going back into the water diving again.
 
Thanks to both of you. Ahh, Searcaigh, another old-timer like myself. I got here in '87 so maybe we dived together way back then. Sure were good times back then.

I want to go out to Similan on March 8th so that's a good six weeks from now. As long as the infection doesn't flare up again I should be good to go. Thanks mucho!
 
Hi Scuba John, I had several students (Marines) that were in my scuba classes, but over a short period of time several of them started showing up with a perforated eardrum. We had a surgeon on base that was a diving doctor and each marine had to see him. Some because of infection received medication, the others had to stay out of the water for two - three weeks. That was routine and everyone of them came back and finished whatever class they were in.
So, I'd say that doctor was pretty much spot on as the perforation itself usually heals quickly. It's the infection that needs to be put down.
The cause was Water Survival Training that was taking place in the day time, my classes were at night. The marines were jumping off a 10 meter platform with gear and going all the way to the bottom 15 ft. Not one of them was told how to clear there ears as they hit the water. When I found out what training they were doing I went in and observed what was happening. After a brief conversion with the instructors they let me teach that part of the training so they could better learn and understand how to teach that part correctly themselves. Needless to say, I didn't have anymore perforated eardrums show up in my classes. Hope this helps and sorry that was a little long. 2-3 weeks is what you're looking for.
 
Two weeks later I go back (yesterday) and the infection has cleared and the hole has closed. Yay.

Thanks all.

Glad they got you fixed up. I just wouldn't push the ear too hard - there may be scar tissue where the perforation healed that could be weak and more vulnerable to injury in the future. If it was a small perforation, the risk of that is probably low. Also would recommend refraining from diving if you still have any pulmonary symptoms.

Best regards,
DDM
 
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