18 yrs old, never able to clear ears

[gj62]

Hi,

I am working with a young girl that has been swimming and snorkeling extensively, but has never been able to clear via the valsalva or other method, only time.

We have done several pool sessions where we try the valsalva, swallowing, jaw movement, etc, but the only successful method is to descend very slowly.

The same is true on ascent. It does not matter how long we have been under, ascending must be done very slowly (5 minutes in a 14' pool).

I'm assuming a physiological problem but wanted to know (a) if anyone has seen this before in an adult, and (b) if it may be worth visiting a doctor to examine her.

She would really like to dive but I am, at best, reluctant to get her certified if this is a permanent issue.

Thanks in advance!

 

[Bratface]

Call DAN and ask for an ENT doctor in your area. She may have very small eustachian tubes or have a history of ear infections that left her with problems. The doctor also may suggest measures or medications that will help her equalize better.

 

[Saturation]

There is also a situation called 'Eustachian tube dysfunction' which is caused by a myriad of minor things that can block the Eustachian tubes. If you follow the treatment regimen for it, you can work out some issues on your own before seeing a doctor.

If you have troubles flying in planes all the time, you will need to see a doctor first. Its the equivalent of of 5-8' dive.

 

[gj62]

Thanks Saturation -

Where would I find the treatment regimen for Eustachian tube dysfunction before going to a doctor?

She does not have pain flying, though she does indicate that her ears bother her...

Thanks!

 

[Saturation]

Thanks Saturation -

Where would I find the treatment regimen for Eustachian tube dysfunction before going to a doctor?

She does not have pain flying, though she does indicate that her ears bother her...

Thanks!

5-Minute Clinical Consult : Eustachian Tube Dysfunction

A simple approach is to use OTC meds which are unlikely to cause trouble with diving. The goal is to allow a patient to self treat symptoms, in most cases ETD is from mild causes. Try each one, eventually all of them, to get the best working combo and avoiding the more side effect prone meds.

Note I've seen compressed gas in dives irritate the ET and nasal mucosa. Whether its the dryness or hyperbaric gas I don't know. It causes a lot of mucus production.

Easy to use drugs that can be used before on just before a dive:

Nasal saline wash to wash clean any residual irritants;
Motrin or Advil: diminishes swelling including those around adenoids;
Benadryl preferred over Claritin and similar, if it makes patients drowsy for diving use Claritin or similar; encourages dryness and eliminates any allergic like reactions; also used to prevent sea sickness;
plain Guaifenesin in double dose, to liquefy mucus, to allow easy clearing.

Side effect prone:

If all above don't work add Afrin nasal spray, local decongestant.

If all above don't work consider Sudafed: warning this maybe hazardous for nitrox and trimix dives; at risk for rebound congestion and reverse block. Probably better to seek medical advice at this level.

Requires doctor input:

Nasal steroids
Antibiotics
Systemic steroids