![]() Symptoms of ear barotrauma: Ear barotrauma usually occurs when the Eustachian tube is blocked due to differences in air pressure. Severe cases may cause damage to the ear and impede your hearing. This is what is known ear barotrauma and is caused by pressure differences inside and outside the ear drum. Note: Do not dive with earplugs, as this may cause external-ear barotrauma.When you travel in an airplane or just come out of the swimming pool, your ears may sometimes block up and even be painful. The inability to equalise properly is disqualifying. If you are unable to equalise, then you may consider ENT consultation. Assess why the problem occurred (lack of training, allergy, etc.) and address each factor. If present, strongly discourage your patient from further diving until properly cleared by a specialist.ĭo not dive until swelling and inflammation have resolved, and you can adequately equalise, preferably under otoscopic evaluation. Vertigo, nystagmus and/or hearing loss might be suggestive of inner-ear barotrauma.Use the O’Neill grading system or detail what you observe.If present, consider referring the patient to an ENT specialist.Assess tympanic membrane perforation (this is sometimes difficult to recognise).Although a middle-ear infection is a plausible secondary complication, this is not always the case in the acute phase. Prophylactic antibiotic therapy is controversial.Provide symptomatic treatment (anti-inflammatory drugs, decongestants, mucolytic agents).An ear, nose and throat (ENT) doctor (otolaryngologist) is ideal for both ear and sinus problems, but your primary care physician can help for most common problems. Don’t worry about referring them to a doctor with dive medicine experience.Have the diver evaluated by a medical professional in a timely fashion.These may indicate a middle-ear infection. Return to your physician if you have worsening pain, fever or discharge.Some of the complications could negatively affect you for the rest of your life. You can consider a return to diving if a physician determines that the injury has healed, and the Eustachian tube is functional.Any doctor should be able to help, regardless of any dive medicine knowledge or training. If the tympanic membrane is ruptured, this might make things worse. Do not put any drops in your ear canal.This might reduce the swelling of the mucous membranes, which may help to open the Eustachian tubes and drain the fluid from the middle ear. Use a nasal decongestant spray or drops.Learn and use proper equalisation techniques.Refrain from diving when feeling popping or crackling in your ears, or if you have a feeling of fullness in your ears after diving.Eardrum rupture, leading to vertigo and hearing loss.Pain increases with descent during diving.Exposure of the normally sterile middle ear to infection from a mixture of pathogens from the non-sterile contents of the ear canal and surrounding water may result in a middle-ear infection. With further descent, the eardrum may rupture, providing pain relief this rupture may cause vertigo and hearing loss. Further descent only intensifies the ear pain, which is soon followed by a serous fluid buildup and bleeding in the middle ear. Poor equalisation techniques or too rapid descent may also contribute to the development of MEBT.ĭivers who cannot equalise middle-ear pressure during descent will first feel discomfort in their ears (clogged or stuffed ears) that may progress to severe pain. Often the injury is serious enough that it causes rupture of the eardrum, tympanic membrane rupture or inner ear barotrauma.įactors that can contribute to the development of MEBT include the common cold, allergies or inflammation - conditions that can cause swelling and may block the Eustachian tubes. Eventually the eardrum may rupture this is likely to bring relief from the pain associated with MEBT, but it is an outcome to avoid if possible. At a certain point an active attempt to equalise will be futile, and a forceful Valsalva maneuver may injure the inner ear. It causes tissue to swell, the eardrum to bulge inward, leakage of fluid and bleeding of ruptured vessels. If the pressure in the tympanic cavity is lower than the pressure of the surrounding tissue, this imbalance results in negative pressure (a relative vacuum) in the middle-ear space. Various maneuvers, such as swallowing or yawning, can facilitate the process.Īn obstruction in the Eustachian tube can lead to an inability to achieve equalisation, particularly during descent, when the pressure changes quickly. This equalisation normally occurs with little or no effort. The Eustachian tube connects the throat with the tympanic cavity and provides passage for gas when pressure equalisation is needed. The air pressure in the tympanic cavity - an air-filled space in the middle ear - must be equalised with the pressure of the surrounding environment.
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