Diving after Tympanoplasty

[helen67]

I saw this Cartilage palisade tympanoplasty and diving. - PubMed - NCBI which seemed positive. Now, I don't know if there are different methods other than what is described in this article. I'm going to schedule an appointment at Mass Eye and Ear to see what the Dr. says. Previously, he said they could do it but we decided to wait to see if I blew it again, that was 4 yrs ago.

 

[helen67]

Hi,
From what my ENT doc told me the surgery isn’t normally very successful (for diving). The “new” skin they put in is too rigid & doesn’t flex enough when equalizing so will normally end up rupturing again. I’m no doctor, this is just what I was told!
My eardrum was destroyed after I was struck by lightning & I was told I’d probably not be able to dive again. After advice from fellow divers & people on this site I bought the IST Pro ear mask & DocPro earplugs. Be very careful when buying the plugs as they come in various different sizes and you need to get the exact one to get the best seal. Also they sell vented & non vented, make sure to get the vented ones! The IST Pro mask has worked very well for me although I’m looking into transplanting the ear muffs & tubes onto my normal mask. I highly recommend it. I hope this helped!

I tried the IST Pro ear mask but I still get leakage, just too much hair. Maybe I was doing something wrong? I do have the ear plug but I was afraid to use it this past trip to keep diving. I didn't want to cause any problems or further damage but it was the vented one. When I get a rupture like this past one, no water gets in and I have zero pain. Bubbles come out but nothing seems to go in so it's a small tear. I'll try the mask again on my next dive trip, see how it goes Thanks for sharing your information, I appreciate it

 

[gert7to3]

Helen,
The ear cup can be a little small for some ears. If your outer ear is not fully contained within the inner ring, inside the Pro-Ear mask ear cup, then you can get leakage. I do sort of a rotational move of the ear cup against the side of my head to make sure my outer ear is completely gathered inside that inner ring. If you feel it leaking you can do this underwater. If you push the top of the ear cup against the side of your head, you can clear it, similarly to the way one clears their mask. It takes a little practice.

Be gentle when donning the mask. The connectors on the equalization tubes can be delicate if you pull on them too hard. I always leave the mask on until I have fully re-boarded the dive boat or walked out of the water.

If you wear the Docs Pro-ear plug as well you will likely avoid getting water deep in your outer ear canal. Note the surface tension of the water over the vent hole can be overcome when you descend more than 20 ft. If you have the Docs Pro-plug on inside the Pro-Ear mask ear cup, you would have to go 20 ft. deeper than whatever depth you had equalized to when the ear cup started leaking.

 

[BGWOJ]

I tried the IST Pro ear mask but I still get leakage, just too much hair. Maybe I was doing something wrong? I do have the ear plug but I was afraid to use it this past trip to keep diving. I didn't want to cause any problems or further damage but it was the vented one. When I get a rupture like this past one, no water gets in and I have zero pain. Bubbles come out but nothing seems to go in so it's a small tear. I'll try the mask again on my next dive trip, see how it goes Thanks for sharing your information, I appreciate it

I had to sacrifice my long hair to get a better seal around my ears but that seemed to be the only option I had to get back in the water! I hope you figure something out & if you come across any new solutions please share!

 

[BGWOJ]

There are a lot of different ways of doing tympanoplasty, and I'm not an otologist, so I might not be up on the latest techniques. But bascially, it's not a question of replacing or reinforcing the TM with something else. The idea is that you put some sort of scaffolding up that helps the natural eardrum grow back. Once the TM is healed, the scaffolding (usually fascia, which is sort of a tough layer that covers muscles) goes away. So people with fully healed TMs can often equalize successfully. Of course, there is a bell curve for everything!

My ENT doc told me that I’ve lost all 3 layers and that they wouldn’t grow back. All I’d get is a really thin layer of scar tissue that won’t hold up to much. Do you have any suggestions of possible surgeries that I could look into!? Thanks.

 

[doctormike]

I can't give you specific advice about your ear over the Internet, but the eardrum has three layers - skin on the outside, mucosa (the lining of the nose and mouth) on the inside, with fibrous tissue between them. By definition, any perforation of the ear means that you have lost all three layers, there is no such thing as just losing one or two of them. The eardrum may heal as a "monolayer", which means skin on the outside, mucosa on the inside with no middle layer. If a diver really stress tests that, they could probably blow it out with a very forceful valsalva equalization, but if they equalize early and often, and don't push a descent where equalization isn't possible, it wouldn't put as much stress on it.

 

[helen67]

I can't give you specific advice about your ear over the Internet, but the eardrum has three layers - skin on the outside, mucosa (the lining of the nose and mouth) on the inside, with fibrous tissue between them. By definition, any perforation of the ear means that you have lost all three layers, there is no such thing as just losing one or two of them. The eardrum may heal as a "monolayer", which means skin on the outside, mucosa on the inside with no middle layer. If a diver really stress tests that, they could probably blow it out with a very forceful valsalva equalization, but if they equalize early and often, and don't push a descent where equalization isn't possible, it wouldn't put as much stress on it.

Dr. Mike, do you think I'm better just leaving it alone? I went 4 years without rupturing the eardrum, so about 200 dives without any problems. This trip, I was on my 38th dive when it happened. What are your thoughts? I do have an appointment next week with an ENT specialist in Boston to get his opinion. I'm really just scared that if I have the surgery it might end my diving all together. Thanks

 

[doctormike]

Well, ear stuff is notoriously difficult to give advice about online - so much depends on the subtle details of what the ear looks like. I can't imagine it making it worse, if there is an intermittent perforation...

 

[helen67]

Well, ear stuff is notoriously difficult to give advice about online - so much depends on the subtle details of what the ear looks like. I can't imagine it making it worse, if there is an intermittent perforation...

Thank you

 

[Jennylinn711]

Hey Helen, I actually just had a tympanoplasty last week at Mass Eye and Ear. You should see Dr. Dennis Poe, he is a really great doctor and surgeon. I had the procedure done to my other ear when I was young and I can tell you that the eardrum moves just fine and I have had no problems diving with it. So much so that I chose to have the other side reinforced so I wouldn't have to worry about my thin eardrum perforating several times during the dive season. Dr. Poe can go over everything with you and can take a look at your Eustachian tubes to evaluate them. Don't worry!!