Blowing snot into your ears?

[Rob9000]

A doc was telling me that another reason to not use the Valsalva maneuver is because you can essentially blow snot in to your middle ear and cause infection problems. I assume this would mean higher risk of reverse block as well. I didn't get much time to talk to him about it, so I was wondering if you all have more info on this.

I usually do the tongue thrust/throat piston with no hands/no pinching kind of thing. If you can clear w/o using a pressurization technique, then are you safer from reverse blocks?

 

[pipefish]

Should have no effect on whether or not you suffer from a reverse block IMO....

 

[muddiver]

It can be an issue if you have a cold. I have found that diving too soon after having a cold or sinus infection can result in an internal ear infection/ache. otherwise, your ears are connected to your sinus anyway, so what keeps the germs out when you are not diving? I wouldn't worry about it.

 

[wreckchick]

I can't see how this could be an issue at all. The Eustachian tubes connect the back of your throat to your middle ear, the sinuses aren't involved at all. Anytime there is difficulty equalizing on descent, there is a risk of a reverse block on ascent.

Rachel

 

[TSandM]

It is possible to blow the contents of your posterior pharynx into your Eustachian tubes; it is unlikely that it will get very far, or cause problems. But this is one of the reasons we are told not to make violent attempts to equalize. If you are using good technique, and anticipating the need, equalizing should always be a gentle procedure.

THIS video is a superb reference -- be prepared; it is about 40 minutes long.

 

[doctormike]

Physiologically and anatomically, this is not much of a clinical problem.

The Eustachian tube isn't a wide open highway (except in rare cases such as after radiation therapy). It is a collapsed, flat tube - supported by stiff cartilage and opened transiently by muscle function. Mainly what goes up the tube during a valsalva maneuver is air. While a minimal amount of pharyngeal secretions might also make its way up the tube, this really should not change the overall environment of the middle ear in terms of bacteria.

Overpressure injury, however, can be a problem, and if you have significant pain with valsalva on descent, better to back off, go slow, and valsalva more gently. You can use one of the other tricks like clicking your jaw - I like the Toynbee maneuver (swallowing with a pinched nose), which is also more gentle.

Of course, this can be more of a problem with a reverse block. To paraphrase our pilot friends: "descents are optional, ascents are mandatory!"

Finally, to clarify, the Eustachian tube opens in the back of the nose, beyond the outlet where the sinuses drain. It is right above the back of the tongue, hidden behind the roof of the mouth. The sinuses drain into the nose, a short distance back from the front of the nostrils...

Mike

 

[Hank49]

Of course, this can be more of a problem with a reverse block. To paraphrase our pilot friends: "descents are optional, ascents are mandatory!"

Mike

Why is it that if you're conjested in your nose that if you do a valsalva it clears the passage for a few seconds?

I've only had a reverse block once and it was painful. I just descended a few feet, pinched my nose and sucked in. Once it popped I equalized with no effort for the rest of the ascent.

 

[doctormike]

Why is it that if you're conjested in your nose that if you do a valsalva it clears the passage for a few seconds?

Do you mean clears the passage in the nose or the ear? The lining of the Eustachian tube is mucosa, the "skin" of the upper airway. Mucosa lines the mouth, the nose, the Eustachian tube and the middle ear. When you have a cold, and are feeling congested, that is swelling in the mucosa that is a part of your body's response to an infection. The swelling isn't limited to the mucosa in the nose, but the Eustachian tube mucosa swells as well. Therefore, with pressure you can force air up the poorly functioning, congested tube, overcoming the swelling of the mucosa.

If you mean the nose, congestion there can also be temporarily relieved by overpressurizing the area, pushing the walls of the nasal cavity apart. It tends to come back pretty quickly, though...

I've only had a reverse block once and it was painful. I just descended a few feet, pinched my nose and sucked in. Once it popped I equalized with no effort for the rest of the ascent.

Yup... can be painful, and since you are ending the dive, and may be low on air, you might not have the luxury of spending a lot of time making a slow ascent, descending a few times, etc...

I had a similar problem with a sinus reverse squeeze... it really never cleared on ascent, and I had to surface with a face full of pressurized air- VERY painful. While this isn't great, it is not as dangerous as a pressure injury to the ear (doctors make terrible patients...). I worked it slowly on the boat, alternating Valsalva and Toynbee maneuvers, until the sinus opened suddenly (with a big rush of bloody mucus!).

There are no words to describe how good that felt...!

 

[iamasmith]

...
The Eustachian tube isn't a wide open highway (except in rare cases such as after radiation therapy). It is a collapsed, flat tube - supported by stiff cartilage and opened transiently by muscle function...

Slightly OT but, I have an anomaly (which I have been assured isn't anything to worry about) where I can hold Eustachian tubes open at will and I can hear rushing sounds coming from my ears when I breath whilst doing it. Sound a bit weird but it is something that I have always been able to do.

The really annoying thing is that for some darn reason I can only do it in one ear when I have the reg in my mouth so I can't rely on that for equalisation all the time :S.

Just thought I would mention it in case anyone knows what this is called (since the docs here are talking about it).

Regards,

-Andy

 

[doctormike]

Slightly OT but, I have an anomaly (which I have been assured isn't anything to worry about) where I can hold Eustachian tubes open at will and I can hear rushing sounds coming from my ears when I breath whilst doing it. Sound a bit weird but it is something that I have always been able to do.

Regards,

-Andy

Yup, sounds something like a "patulous Eustachian tube", which means that the tube is abnormally open. usually this is in the context of damage to the tube (such as by radiation), but I have heard of people being able to consciously open their tubes completely, leading to symptoms like this. Hearing your own voice loudly in this situation is called autophony, and some people hear the noise of airflow through their upper airway when the tube is wide open...

Mike