Bubbles coming from ear and injury

[peeweediver]

Disclaimer: I'm not Dr. Mike and did not stay at a Holiday Inn Express last night. However, a left ear barotrauma from way too way up-downs when teaching students in a quarry did lead to acute otitis media, which then led to a pinpoint rupture of the ear drum from the spot of a big bulging ( it seemed like gallons of yellow pus ran down my left side of my neck....while standing in line for a hot dog at the Cubs game...no pain), which then led to a tympanogram (which I failed). One week later the rupture healed. ENT kept me out of the water for 4 months. Lost some hearing in left ear and it's still lost, but not all lost. Been diving fine for a year since healing. One major concern for Dr. Mike to opine: I did read about another condition which could result in the pain behind the ear divingsafari pictured. I can't remember the condition and it's related to middle-inner ear infections, but wondered if you knew.
Diving safari: there can definitely be diving life after an ear drum rupture, especially a pinpoint rupture. Just stay out for enough time that your ENT says, "Good to go". My first diving after healing (with a few tests to the bottom of a pool) was at CoCos Island which required negative entries to 100 feet. Luckily, all went swimmingly....pun intended. Good luck and take care.

Rob

 

[doctormike]

The bottom line with ear stuff is that you simply can't know what is going on without a thorough exam by someone with experience with ears. Unfortunately, many diving injuries happen far from these facilities, so people are forced to do the best that they can with limited information.

A lot of this stuff is covered in the article linked above. Remember, there is a difference between acute otitis media (treated with antibiotics) and middle ear barotrauma resulting in perforation and drainage. I'm just careful when using these terms because they mean different things, and I'll just leave it at that.

The tympanogram will basically either give you a curve with a peak or a flat curve. A flat curve comes from one of two things - fluid behind the eardrum with no perforation, or a perforated eardrum. You can tell the difference by the measurement of the canal volume...

 

[peeweediver]

Dr. Mike, as I usually do with your posts, totally agree. I should only list symptoms, not diagnosis. My ENT thought it was an infection, while the first one who looked at it thought it was the barotrauma. Go figure. I will say that my ENT said the flat reading was from fluid in the middle ear because the test was a month after ear drum healed. Moral of the story, seek professional help and rely on their wisdom. My encouragement is just to say, if all goes well, diving again is possible and will still be tons of fun.
Rob

 

[doctormike]

Oh, absolutely, I agree with you! A perforated TM often sounds worse than it is, and once healed (surgically or spontanously) can usually withstand equalization just fine.

I just always note that terms are often used inexactly in my field. For example - if you have a perforated eardrum, go diving, and then get otorrhea (drainage), that could correctly be termed an "ear infection". If you get a cold and it extends to your ears and you get pus behind an intact eardrum, that could be called an "ear infection". And if you dive a lot with earwax that gets wet and you get a swimmer's ear, that's also called an "ear infection". The problem is that these three things have little to do with each other and are treated differently, so I'm always careful to put context into these discussions, since once people start using these terms it can get very confusing, especially since there are rarely accurate diagnoses out there...

Dive safe!

Mike

 

[gkwalt]

This was as a result of perforated TM.

 

[billt4sf]

What are you asking ME for? Get to an ENT and call DAN! And take the freaking meds.

- Bill

 

[divingsurfari]

Hi, in the months leading up to Xmas, I noticed a ringing in my left ear when I went to bed at night. After New Year, this seemed to have gone away.

Overall it certainly seems to have improved. I no longer get the inflammed feeling behind the ear (see photo with shaded area).

Anyway, I recently saw the ENT specialist. I did another tymphanometry test on the affected ear and the result wasn't the same as last time (last time it seemed to be conclusive that there was a hole in the ear because there was no reading on the machine i.e. air going straight through). So, this time the test gave a reading for the affected ear which wasn't the same as the healthy right ear, but it was still a reading. So I suppose that's good.
Anyway, they've discharged me.

Thanks for the support and advice!