Diving Modification For Weakened Ear Drum

[MB NZ]

Yes I got water in my middle ear and it was not fun. It got infected and I was remote (living on a sailboat) with no medical care so it was just my wife (nurse) and some antibiotics to get me through. Luckily no permanent damage.

I am good at managing risk, I just want to educate myself to reduce risk to an acceptable level. Like I said, probably just shallow dives and pro-ears with Doc's Pro Plugs to catch splashes of water if they get in the ear-cup while I surface immediately. I don't dive with paid tours and groups, just my wife and friends so no pressure to go deep or continue with the dive if some water gets in my ear cup. The Pro-ears are pretty reliable if used properly.

Your risk management is for you to decide. I obviously had my reasons at the time to do what you describe. I found the ProEar mask to be reliable, but not 100%. Being bald helped! Good luck, I hope it goes well.

 

[altsaint]

Yes I got water in my middle ear and it was not fun. It got infected and I was remote (living on a sailboat) with no medical care so it was just my wife (nurse) and some antibiotics to get me through. Luckily no permanent damage.

I am good at managing risk, I just want to educate myself to reduce risk to an acceptable level. Like I said, probably just shallow dives and pro-ears with Doc's Pro Plugs to catch splashes of water if they get in the ear-cup while I surface immediately. I don't dive with paid tours and groups, just my wife and friends so no pressure to go deep or continue with the dive if some water gets in my ear cup. The Pro-ears are pretty reliable if used properly.

Your strategy was what I was intending to do on a dive trip I have just returned from, i.e. I took pro-ears and pro-plugs to use if I perforated my TM a third time (I am the OP, BTW).

I was fully expecting to be three times unlucky, but wasn't. My dives were no more than two per day, spread over 5 days, depths no deeper than 15m.

Something I did have was some impacted ear wax that was trapping air and water. The noise and sensations of that were really worrying after two previous trips resulting in perforations. Having the wax removed was not an option. So I used the pro-ear mask for the first time.

It was fairly good and the ear pockets didn't leak too much. I'm sure they wouldn't leak at all if my hair was cut much shorter around the ear and with a bit more practice. I didn't use the pro-plugs as I didn't want to push the wax any further back in the canal.

Looking back, if I had perforated my TM again on the trip, I would have combined the pro-ears and pro-plugs, and if water had made it past those two, plus the wax plug and entered the middle ear, then I'd have stopped the diving at that point. I accept that is taking a risk, and not something I'd advise anyone else to do.

Obviously I'm glad to have done 9 dives in a row with no rupture.

 

[mike41799]

I have the same problem, and a failed tympanoplasty with no desire to do that surgery again. I was wondering if the pro-ear (I have experience with pro-ear) combined with a custom ear plug would provide protection for my middle ear. Normally an ear plug would ensure immediate TM failure while diving but I have a hole in my TM that will never heal, so not a problem with TM pressure. I am an airline pilot so I am constantly reminded that I only have to equalize one ear.

I fly frequently, it is a pain. I would not use the plugs though. I was using this in combination with docs pro plugs and the fitted hood, but overtime they have become unnecessary. The mask works fine by itself, especially if you can be shaven all around your ear.

 

[Ellabee83]

Thanks VikingDives, although I can't see how the perforation and bubbles coming out aren't related. There was no more equalisation - all the air I was pushing through my ET was coming out of my ear, however small the rupture may have been.

Both ruptures were in warm water (28 degrees C) or thereabouts.

I did contact DAN about a week ago, and they were helpful, but said, "Diving ENTs are actually rare, and unfortunately, we are not aware of any within the UK".

I'm cautious about proplugs - they have a small hole to let water in and if that gets blocked by wax or something, I'd worry about an external ear squeeze. Happy to be challenged on that though.

I have ETD and had a bad dual perf last April. I actually think, in hindsight, that my ears perf every dive, but only minorly. I had glue ear and grommets as a kid until 12yo. Started diving 2022, and all was fine (as far as i was aware, but always had a popping sensation, same as I get on a plane or at height). April, I had a bad perf with blood and fluid, and a series of recurrent infections. I bought a digital phone-linked otoscope so I could keep an eye and avoid water when needed. I found my ears were perforating every few days with no trigger.

I dived this week and felt the same familiar pop as I've always felt, and it's popped again. I was using doc's pro plugs at the time, and it made no difference to me at all unfortunately.

 

[scubaozy]

I have ETD and had a bad dual perf last April. I actually think, in hindsight, that my ears perf every dive, but only minorly. I had glue ear and grommets as a kid until 12yo. Started diving 2022, and all was fine (as far as i was aware, but always had a popping sensation, same as I get on a plane or at height). April, I had a bad perf with blood and fluid, and a series of recurrent infections. I bought a digital phone-linked otoscope so I could keep an eye and avoid water when needed. I found my ears were perforating every few days with no trigger.

I dived this week and felt the same familiar pop as I've always felt, and it's popped again. I was using doc's pro plugs at the time, and it made no difference to me at all unfortunately.

Sorry to hear that. I think you need to address ETD first and next step would probably be a patch or a tympanoplasty. In your condition, I would stay away from diving until addressing all the issues mentioned. I am not a doctor, so take my advice with salt of grain but please first consult with an ENT who is specialized in diving.

 

[Ellabee83]

Sorry to hear that. I think you need to address ETD first and next step would probably be a patch or a tympanoplasty. In your condition, I would stay away from diving until addressing all the issues mentioned. I am not a doctor, so take my advice with salt of grain but please first consult with an ENT who is specialized in diving.

I've seen several ENTs and dive specialists who have said I'm good to continue diving. I have a spray for the EDT but it gives me chronic migraines so have to use selectively. I don't want to be deaf, so keeping them dry!

 

[altsaint]

I have ETD and had a bad dual perf last April. I actually think, in hindsight, that my ears perf every dive, but only minorly. I had glue ear and grommets as a kid until 12yo. Started diving 2022, and all was fine (as far as i was aware, but always had a popping sensation, same as I get on a plane or at height). April, I had a bad perf with blood and fluid, and a series of recurrent infections. I bought a digital phone-linked otoscope so I could keep an eye and avoid water when needed. I found my ears were perforating every few days with no trigger.

I dived this week and felt the same familiar pop as I've always felt, and it's popped again. I was using doc's pro plugs at the time, and it made no difference to me at all unfortunately.

Also sorry to hear of your issues. Are you sure you are getting a perforation? It does sound as if you are if you have bleeding and infection, but still it would be good to get that confirmed by a doctor soon after it has happened. On the other hand, if you equalise and air bubbles out through the ear, then that's pretty definite.

It seems from posts so far, that the pro-ear mask is worth a try. Might not prevent the perforation, but will stop water getting into the ear (as long as the ear cups are sealed).

 

[Duke Dive Medicine]

I've seen several ENTs and dive specialists who have said I'm good to continue diving. I have a spray for the EDT but it gives me chronic migraines so have to use selectively. I don't want to be deaf, so keeping them dry!

That's interesting in light of your post that you think your TMs perforate on every dive. What did your ENT and dive consultants say when you told them that?

Best regards,
DDM

 

[mike41799]

I have the same problem, and a failed tympanoplasty with no desire to do that surgery again. I was wondering if the pro-ear (I have experience with pro-ear) combined with a custom ear plug would provide protection for my middle ear. Normally an ear plug would ensure immediate TM failure while diving but I have a hole in my TM that will never heal, so not a problem with TM pressure. I am an airline pilot so I am constantly reminded that I only have to equalize one ear.

When I started, I would wear the pro-plugs with the ProEar mask. I have gotten away from that, since the ProEar system keeps my ears dry. If a little water does get in the ear up, I just tilt my head to that side and end the dive. I have never had it completely flood

 

[altsaint]

My last trip I took my ProEar, but one ear cup flooded, and I was chilly on the dive without a hood, so I gave up using it. We were shore diving in depths that were no deeper than 7m, and there was a lot of surge - frequent ups and downs and frequent equalisations. On my 9th dive, I started to descend and as I equalised I heard a crackle, followed by a stream of bubbles flowing out of my right ear. So this is now the third time this ear has perforated.

I need to be a bit more serious about addressing the underlying cause, which is the ETD. The ETD means I am using more air pressure to equalise, and this is stressing a weakened TM.

However, the dive trip prior to this one I managed 11 dives and had no incident. There were fewer equalisations per dive on that trip, so I guess I was reducing my odds.

If I don't get the ETD resolved before a future trip, then I'll be making sure I persevere with the ProEar, and just be ultra-cautious. Any discomfort or gurgling in the ear means take at least one day off, or consider snorkelling instead.

One useful outcome this time, was finding an ENT consultant who was a PADI DM as well. In the UK he took a long time to track down.