Retracted Eardrum & Diving?

[Ste Wart]

So a slow start to this year's dive season has been compounded by tinnitus; in one ear, forcing me to stay out of the water.

I've just got back from the ENT and after a bit of digging, and I mean literally, he informed me I've got a retracted ear drum, which may or may not have caused the tinnitus. So he's now referred me to a surgeon.

Now I'm at the sit and wait stage.

Has anyone had any issues with a retracted ear drum? And more importantly is it likely to lead to me being a permanent landlubber?

 

[doctormike]

Hi,

A retracted eardrum can mean a lot of things, but generally it means a very minor degree of dysfunction of the Eustachian tube (the tube that ventilates the space behind the eardrum into the airway) causing relatively low pressure in the middle ear. Almost anyone with a cold might have a retracted eardrum, that by itself doesn't necessarily mean anything.

However, it has been my experience that the ear is not familiar territory for doctors who aren't ENT docs or pediatricians - don't mean to sound arrogant, and I know that most GPs are a lot smarter than me! But the bottom line is that you don't really have a diagnosis, you need an exam by an ENT doctor and an audiogram to figure out what is going on.

Here is my sticky on ear disease in diving: http://www.rothschilddesign.com/ear_scuba

Best,

Mike Rothschild

 

[uncfnp]

Hi,

A retracted eardrum can mean a lot of things, but generally it means a very minor degree of dysfunction of the Eustachian tube (the tube that ventilates the space behind the eardrum into the airway) causing relatively low pressure in the middle ear. Almost anyone with a cold might have a retracted eardrum, that by itself doesn't necessarily mean anything.

However, it has been my experience that the ear is not familiar territory for doctors who aren't ENT docs or pediatricians - don't mean to sound arrogant, and I know that most GPs are a lot smarter than me! But the bottom line is that you don't really have a diagnosis, you need an exam by an ENT doctor and an audiogram to figure out what is going on.

Here is my sticky on ear disease in diving: http://www.rothschilddesign.com/ear_scuba

Best,

Mike Rothschild

Hi doctormike,

It sounds like he DID see and ENT but I'm with you that it sounds (forgive the pun) very odd. Tinnitus in and of itself has many causes, many of which are nondive related but can be associated with age and hearing loss. Was a hearing test done?

And a retracted eardrum is often temporary. To the OP, have you had cold or allergy symptoms? Do you have a history of ear problems, diving or otherwise? And why the referral to a surgeon for this. Does he think you need a tube inserted? Does ENT not do this in England? I would think that surgery would indeed effect future diving.

 

[Ste Wart]

Hi,

A retracted eardrum can mean a lot of things, but generally it means a very minor degree of dysfunction of the Eustachian tube (the tube that ventilates the space behind the eardrum into the airway) causing relatively low pressure in the middle ear. Almost anyone with a cold might have a retracted eardrum, that by itself doesn't necessarily mean anything.

However, it has been my experience that the ear is not familiar territory for doctors who aren't ENT docs or pediatricians - don't mean to sound arrogant, and I know that most GPs are a lot smarter than me! But the bottom line is that you don't really have a diagnosis, you need an exam by an ENT doctor and an audiogram to figure out what is going on.

Here is my sticky on ear disease in diving: http://www.rothschilddesign.com/ear_scuba

Best,

Mike Rothschild

Er. My post said I just got back from the ENT.

He dug some skin out of a retraction in my ear drum. I've got hearing loss (now improving) and tinnitus in one ear. Which I knew but my audiogram confirmed

And a retracted eardrum is often temporary. To the OP, have you had cold or allergy symptoms? Do you have a history of ear problems, diving or otherwise? And why the referral to a surgeon for this. Does he think you need a tube inserted? Does ENT not do this in England? I would think that surgery would indeed effect future diving.

No cold or allergy. No history of ear problems, quite the reverse.

ENT is the specialist in the UK. But Ear surgeons operate. Which I only found out today after he referred me to an Ear Surgeon.

 

[uncfnp]

Er. My post said I just got back from the ENT.

He dug some skin out of a retraction in my ear drum. I've got hearing loss (now improving) and tinnitus in one ear. Which I knew but my audiogram confirmed



No cold or allergy. No history of ear problems, quite the reverse.

ENT is the specialist in the UK. But Ear surgeons operate. Which I only found out today after he referred me to an Ear Surgeon.

Sorry Ste Wart,

Sounds like more than a simple retracted eardrum. Hope it all turns out well.

 

[Duke Dive Medicine]

He dug some skin out of a retraction in your eardrum... did he use the word cholesteatoma?

 

[Ste Wart]

. did he use the word cholesteatoma?

He didn't. I wiki'd that just now. Aside from the tinnitus I don't have any of the symptoms. Balance is fine, no discharge.

What he removed was skin-coloured. From what I could see through watering eyes.

 

[uncfnp]

He dug some skin out of a retraction in your eardrum... did he use the word cholesteatoma?

I thought of that too but a cholesteatoma is behind the tympanic membrane and there is typically a history of ear issues but a surgical referral would be appropiate.

Ste Wart, did the ENT say what they expected the surgeon to do? By this I mean what type of surgery?

 

[Ste Wart]

I thought of that too but a cholesteatoma is behind the tympanic membrane and there is typically a history of ear issues but a surgical referral would be appropiate.

Ste Wart, did the ENT say what they expected the surgeon to do? By this I mean what type of surgery?

The ENT said he was covering bases. The retraction may be hiding a bigger retraction that he couldn't see, which could lead to infection and the affect the bones in the ear, hearing etc etc.

So there may be no surgery at all, but he basically told me to plan for the worst and hope for the best.

 

[uncfnp]

Sounds like he may be ruling out a cholesteatoma or tumor with the referral. I good idea but I would take your lack of other worrisome symptoms as a good sign. And an ENT should be able to see a cholesteatoma in the office. There would only be drainage if the eardrum had been perforated.

Surgery would likely only be needed if he/she saw a tumor (surgical removal) or the retraction was chronic and causing problems (tubes).

Hard to say over the internet but could it have been wax that he removed from the canal? Sometimes, if it is stubborn, a little superficial adherent skin may come away too.