Diving Modification For Weakened Ear Drum

[Angelo Farina]

BTW, I know I said I used valsalva on the original post, but I used that term as it is more well-known. I actually use Frenzal from my freediving days, never Valsalva. Sorry to be misleading there.

Well, Frenzel can be performed only with the mouth closed.
Altough I have seen some free divers to use it while scuba diving (removing the reg from the mouth, equalising, and placing the reg in mouth again), I suppose that what you are currently using is some other technique, which is possible with the mouth open. Possibly Marcante-Odaglia (which uses the soft palate, but not the tongue as in Frenzel) or Toynbee.
Some divers with equalising problems develop their own personal method, often as a mixture of other ones.
However the name is not important, what matters is to open the Eustachian Tube and get equalisation.
If this is difficult in one of your tubes due to a long-term condition, you should evaluate a medical procedure for solving the problem permanently.
My wife also had problems, and her ENT suggested a balloon tube dilation procedure.
Luckily enough she solved her problem when she did follow the instructor course at the Nervi Training Center, where Duilio Marcante in person taught her how to equalise with the Marcante-Odaglia method.
But you are already beyonds this point, which was the second in my list.
So you are back to the first point: ask your ENT about possibilities for permanently solving your narrow tube problem.
You could also evaluate this DAN equaleasy workshop. One of my colleagues who had recurring equalisation problems got great improvement from it: DAN Europe - EqualEasy - course - DAN Europe - EqualEasy - course

 

[Richard Dayan]

I am expert in this. First use ear plugs when diving, OKEN brand works, second use heated diving gear dry suit with heat vest

 

[altsaint]

Replies so far have been helpful, partly in the sense that I realise now I should have asked more specific questions originally. These being:

1. Do frequent repetitive equalisations stress the eardrum enough to the point that a previously ruptured eardrum may again rupture?
2. Has anyone experienced an eardrum perforation, and then made modifications to the way they dive that have prevented it happening again?

I have now added these to the original post.

 

[MB NZ]

You could take the point of view that repeated, controlled stresses without rupture would strengthen the ear drum. That's how biological systems tend to work, but again, it's an unknown. Regardless, I would have thought that regular equalisation (above or below the water) would benefit your ETD. Disclaimer, I am a doctor and have a passing interest in ENT due to my own problems, but I'm not an ENT doctor and medical advice that you get on the internet is worth what you pay for it!

 

[altsaint]

Well, Frenzel can be performed only with the mouth closed.
Altough I have seen some free divers to use it while scuba diving (removing the reg from the mouth, equalising, and placing the reg in mouth again), I suppose that what you are currently using is some other technique, which is possible with the mouth open. Possibly Marcante-Odaglia (which uses the soft palate, but not the tongue as in Frenzel) or Toynbee.
Some divers with equalising problems develop their own personal method, often as a mixture of other ones.
However the name is not important, what matters is to open the Eustachian Tube and get equalisation.
If this is difficult in one of your tubes due to a long-term condition, you should evaluate a medical procedure for solving the problem permanently.
My wife also had problems, and her ENT suggested a balloon tube dilation procedure.
Luckily enough she solved her problem when she did follow the instructor course at the Nervi Training Center, where Duilio Marcante in person taught her how to equalise with the Marcante-Odaglia method.
But you are already beyonds this point, which was the second in my list.
So you are back to the first point: ask your ENT about possibilities for permanently solving your narrow tube problem.
You could also evaluate this DAN equaleasy workshop. One of my colleagues who had recurring equalisation problems got great improvement from it: DAN Europe - EqualEasy - course - DAN Europe - EqualEasy - course

Hi Angelo - my version of Frenzel is to create a chamber in the mouth where the soft palate blocks the trachea (preventing valsalva) and the tongue blocks the front of the mouth (preventing air exiting out through the reg). Nose seal using fingers as normal. The pressure created in the chamber connects to the ET's. Is there a different name for that?

My previous ENT specialist mentioned the balloon tube dilation and recommended me to not go down that route. He said it could cause me more problems and may not solve the issue anyway. Obviously his other advice was not good, but I hope some of what he said was accurate!

My next steps will be to manage the ETD as best as possible with decongestants, and more importantly as you have suggested, better equalisations.

However, in addition to this, I have now realised there are some specific questions I could do with addressing, and which I edited into my original post.

 

[Angelo Farina]

Hi Angelo - my version of Frenzel is to create a chamber in the mouth where the soft palate blocks the trachea (preventing valsalva) and the tongue blocks the front of the mouth (preventing air exiting out through the reg). Nose seal using fingers as normal. The pressure created in the chamber connects to the ET's. Is there a different name for that?

That's very interesting! This falls in one of those inermediate cases which people with ewualisstion problemscdevelop on tgeir own.
Your usage of the soft palate corresponds with Marcante-Odaglia. But in ths technique (which was developed for military corps using pure-oxygen CC rebreathers) the airways to the mouth remains open, you continue breathing normally while equalising.
Your closore of the mouth using the tongue is similar to pure Frenzel, so I would define your technique a modified Frenzel (reg in mouth instead of mouth closed).
I have seen a simikar technique used by athlets playing underwater hockey.
Deep free divers usually spit out the snorkel, or simply do not use it, as it is dangerous and causes drag.
Instead in underwater hockey they keep the snorkel in mouth, for quickly breathing on surface and then diving again. So they use a modified Frenzel with the snorkel in mouth.
I also do not know if this method has a specific name.
However it looks a good method for your condition, avoiding to use lungs as it happens in Valsalva.
I also started with free diving, and I learned BTV way before tgst name was given.
I was 10 years old, and I was not understanding while all others had this need of closing their nostrils for equalising.
Only 15 years later I understood that I was using BTV.
And unfortunately only one diver over five can use it constantly, as I discovered when working as an instructor.
I was always very interested in the various equalisation methods, whilst many other instructors where teaching only the crap and dangerous Valsalva method.
I was very interested also because my girlfriend was suffering of a monolateral tube restriction.

 

[altsaint]

That's very interesting! This falls in one of those inermediate cases which people with ewualisstion problemscdevelop on tgeir own.
Your usage of the soft palate corresponds with Marcante-Odaglia. But in ths technique (which was developed for military corps using pure-oxygen CC rebreathers) the airways to the mouth remains open, you continue breathing normally while equalising.
Your closore of the mouth using the tongue is similar to pure Frenzel, so I would define your technique a modified Frenzel (reg in mouth instead of mouth closed).
I have seen a simikar technique used by athlets playing underwater hockey.
Deep free divers usually spit out the snorkel, or simply do not use it, as it is dangerous and causes drag.
Instead in underwater hockey they keep the snorkel in mouth, for quickly breathing on surface and then diving again. So they use a modified Frenzel with the snorkel in mouth.
I also do not know if this method has a specific name.
However it looks a good method for your condition, avoiding to use lungs as it happens in Valsalva.
I also started with free diving, and I learned BTV way before tgst name was given.
I was 10 years old, and I was not understanding while all others had this need of closing their nostrils for equalising.
Only 15 years later I understood that I was using BTV.
And unfortunately only one diver over five can use it constantly, as I discovered when working as an instructor.
I was always very interested in the various equalisation methods, whilst many other instructors where teaching only the crap and dangerous Valsalva method.
I was very interested also because my girlfriend was suffering of a monolateral tube restriction.

I think this method emerged for me because I have both freedived and scuba dived. On competitive freedives I was hitting depths around 70m, so not only is frenzel necessary, but also the 'mouthfill' technique where you keep a reserve of air puffed into your cheeks just for equalisation. So when scuba diving it was easier for me to modify frenzel instead of doing something completely different.

Of course it is ironic that I used to do this type of diving a few years back, and now have ear difficulties at relatively shallow depths ( I mean, I used to easily safety dive and warm-up to 20m depths when freediving, which is now where my eardrum goes boom).

 

[Litos]

Replies so far have been helpful, partly in the sense that I realise now I should have asked more specific questions originally. These being:

1. Do frequent repetitive equalisations stress the eardrum enough to the point that a previously ruptured eardrum may again rupture?
2. Has anyone experienced an eardrum perforation, and then made modifications to the way they dive that have prevented it happening again?

I have now added these to the original post.

My ENT explained me the risk of repetitive valsalva maneuvers... The point is how gentle is defined.

On the other hand, eardrum is a membrane, and prolonged dive days without the possibility of drying between dives cause it to be softer and more prone to infections and tears (as skin).

I would give a go to vented earplugs, plus a cleaning and drying routine, so you keep your eardrum as dry as possible. Slow equalization and descent, for sure.

I had myself a ruptured eardrum a couple of years ago and I am quite prone to infections. But I am not a doctor.

 

[altsaint]

My ENT explained me the risk of repetitive valsalva maneuvers... The point is how gentle is defined.

On the other hand, eardrum is a membrane, and prolonged dive days without the possibility of drying between dives cause it to be softer and more prone to infections and tears (as skin).

I would give a go to vented earplugs, plus a cleaning and drying routine, so you keep your eardrum as dry as possible. Slow equalization and descent, for sure.

I had myself a ruptured eardrum a couple of years ago and I am quite prone to infections. But I am not a doctor.

OK, that's really interesting and makes a lot of sense, about keeping the eardrum dry. And, where I have been skeptical about the use of vented earplugs and pro-ear mask, this would be a good reason to reconsider. Thank you @Litos for your suggestion.

 

[mike41799]

I have a perforated eardrum, can't go underwater at all. I Dive successfully with the IST ProEar mask.