EtD or something else??

[James horton]

Hi there, I'm new to the board and i was wondering if I could get peoples opinion on something. I am a working dive instructor currently in Timor Leste. I have been here for nearly 6 months and for the vast majority of this time I have had problems with my left ear. I should start by saying that while diving over the last 2 years I have never had a problem with my ears and so this has only developed since being here.
I did have what seemed a minor ear infection at the beginning of my time here and also suffered a bit with swimmers hear. Then I started to find that I couldnt equalise my left ear when descending. It meant I was limited to a certain depth and no matter what I did it wouldn't clear. I never have a problem equalizing on the surface although I found that my left ear needed to be equalised on the surface as was a bit plugged. Since then it has improved somewhat but I have found that I can equalise on the way down but sometimes I might need to change my depth and when I try to equalise I can feel that my ET has collapsed and I can't open it unless I rise a few feet where I feel the tube unlock when gas is released and then try again. Sometimes it will equalise once or twice but will then lock again. I Can almost tell when diving when it is going to lock as my ear feels a little bit strange. I have tried auto insufflation, nasal steroids, Anti inflammatory medications an ear drops. Nothing seems to have helped to return it to normal. I have visited a Dr here (not ENT) who gave me ear drops and said it sounds a little like ETD and nothing to worry about (ear drum looked fine just external inflammation.) I do leave here in 2 weeks and plan to go to an ETD doctor as soon as I'm close. In the meantime i would appreciate anybody's opinion or encountered something similar. Thanks

 

[Duke Dive Medicine]

Hi James, it sounds like you keep re-injuring the ear. It can take quite some time for inflammation from ear barotrauma to resolve, and if you continue to dive and stress the area, it can cause further damage. Ear drops won't do anything for this since they only treat the external ear canal. This isn't a recommendation for you in particular, but some people find oxymetazoline (Afrin, others) nasal spray and pseudoephedrine (Sudafed, others) beneficial. Caution is advised if using decongestant medications while diving because they can wear off while a diver is still at pressure. Go slowly on descent, equalize early and often, and pre-load your ears by performing a Valsalva (pinch and blow) maneuver before descent.

Best regards,
DDM

 

[James horton]

Hi DDM

When you said if you continue to dive and stress the area it can cause more damage. What area are you referring to?
Thanks for your help.

 

[Duke Dive Medicine]

Hi DDM

When you said if you continue to dive and stress the area it can cause more damage. What area are you referring to?
Thanks for your help.

Hi James, sorry if that wasn't clear. I meant specifically the mucous membrane around the Eustachian tube and its opening in the nasopharynx. If that area is inflamed it's probably swollen, which would tend to close off the opening of the Eustachian tube and make it more difficult to equalize. Descending in that condition can lead to further inflammation in the area. I'm linking an article on barotrauma below; it has diagrams and a more detailed explanation.

https://www.diveassure.com/wp-conte...s-Eric-Hexdall-RN-CHRN-Duke-Dive-Medicine.pdf

Best regards,
DDM

 

[James horton]

That's really good information DDM thanks for that. So if I give my ears a good rest ( I'm not diving now for 2 months) they should return back to normal once the inflammation has started to die down? Thanks

 

[Duke Dive Medicine]

That's really good information DDM thanks for that. So if I give my ears a good rest ( I'm not diving now for 2 months) they should return back to normal once the inflammation has started to die down? Thanks

You're most welcome. It's not unheard of for ear inflammation to take 8+ weeks to resolve so if you do go diving soon, I'd recommend that you take it slow and not push yourself if you start to feel discomfort.

Best regards,
DDM

 

[James horton]

And so I should not experience any long lasting damage due to the inflammation? I'm hoping it will return back to normal once it has sufficient rest.

 

[James horton]

Sorry for all the questions. I'm just wanting to get as much information as possible from experts like yourself. Really appreciate it.

 

[Duke Dive Medicine]

And so I should not experience any long lasting damage due to the inflammation? I'm hoping it will return back to normal once it has sufficient rest.

Hi James, in all likelihood your ears will go back to baseline given enough time.

Best regards,
DDM

 

[James horton]

Thanks DDM. I really appreciate all of your assistance.