Diving with a vent tube in ear??

[9supratt4]

I posted this in the diving with disabilities section, but it was suggested I post it here as well.....

I have a friend who has always wanted to dive and now that I am certified and diving he is extremely jealous!! The problem is that one of his ears has a permanent tube in it. His Eustachian tube instead of going from the ear straight down into the throat, has a "notch" in it where his tube will not drain correctly and allows fluids to build up in the "gully" inside the tube, and he had major ear infections as a child, hence the permanent tube.

He recently went to see a dive ENT who told him that he could not dive with a tube in his ear. He did ask the Dr. about using the Doc's Pro Plugs, and the Dr. basically said that he can't say that yes they will work because the correct answer is he shouldn't be diving with a tube.

What does everyone else think?? Anyone have experience with these ProPlugs?? Is he attempting to do something that he really shouldn't be doing?? Or can this work??

I told him to fill his ear with concrete since he can't hear through it anyway....lol.

 

[fire_diver]

Do what the doc said, no diving.

 

[doctormike]

I posted this in the diving with disabilities section, but it was suggested I post it here as well.....

I have a friend who has always wanted to dive and now that I am certified and diving he is extremely jealous!! The problem is that one of his ears has a permanent tube in it. His Eustachian tube instead of going from the ear straight down into the throat, has a "notch" in it where his tube will not drain correctly and allows fluids to build up in the "gully" inside the tube, and he had major ear infections as a child, hence the permanent tube.

He recently went to see a dive ENT who told him that he could not dive with a tube in his ear. He did ask the Dr. about using the Doc's Pro Plugs, and the Dr. basically said that he can't say that yes they will work because the correct answer is he shouldn't be diving with a tube.

What does everyone else think?? Anyone have experience with these ProPlugs?? Is he attempting to do something that he really shouldn't be doing?? Or can this work??

I told him to fill his ear with concrete since he can't hear through it anyway....lol.

As much as I encourage diving, I would have a problem with this. There is no way of ensuring that this won't be a problem at depth. The risk would be of seawater being forced into the middle ear during descent, with the possibility of permanent hearing loss. Worse, this could set him up for sudden pain/vertigo/disorientation, which could have serious consequences in a new diver. The proplugs might help, but they would have to be vented, and couldn't guarantee protection of the middle ear...

Remember, this is for most of us a recreational hobby, not something that we have to do... so the threshold is pretty low for a medical exclusion. I'm sure that there are some people who have learned how to dive with a non-intact tympanic membrane, but that doesn't make it a good idea for someone just starting out...

Just my 2 cents..!

Mike

 

[9supratt4]

Is there a surgery that can be used to correct his problem?? Even though he may not be able to dive for a year or so after, but what's the difference, he can't dive now anyway...lol.

I'm still down for filling his ear with concrete.

 

[doctormike]

Is there a surgery that can be used to correct his problem?? Even though he may not be able to dive for a year or so after, but what's the difference, he can't dive now anyway...lol.

I'm still down for filling his ear with concrete.

I really couldn't say anything specific over the Internet, especially without details... but there is no good operation to "fix" the Eustachian tube. However, there may be other problems that are amenable to surgery - he would need to ask his otologist (ear specialist)...

Mike

 

[9supratt4]

I really couldn't say anything specific over the Internet, especially without details... but there is no good operation to "fix" the Eustachian tube. However, there may be other problems that are amenable to surgery - he would need to ask his otologist (ear specialist)...

Mike

Mike.....I appreciate all your help!! He did see an ENT that was referred by DAN as a Dive Specialist ENT. The doctor is on Park Ave. in Manhattan. My friend needs to go for a CAT Scan as the doctor said he saw some polyps in his ear, which I understand to be pretty common.

And although he really really wants to dive...he knows that trying to do so without a fix for his problem and against his doctors recommendations are not just stupid, but could do even more damage.

 

[doctormike]

Mike.....I appreciate all your help!! He did see an ENT that was referred by DAN as a Dive Specialist ENT. The doctor is on Park Ave. in Manhattan. My friend needs to go for a CAT Scan as the doctor said he saw some polyps in his ear, which I understand to be pretty common.

And although he really really wants to dive...he knows that trying to do so without a fix for his problem and against his doctors recommendations are not just stupid, but could do even more damage.

Hey, that's where my office is too! PM me with his name, if you like, I might know him or her...

And I'm glad that he understands that this isn't the sort of thing where you should push the envelope...

 

[John C. Ratliff]

I just posted this an the Divers with Disabilities threads, but I think it should also be posted here:

Okay, I have to say something here. First, the problem is getting water into the middle ear, not clearing the ear. The pressures will be equalized because of the hole in the ear drum. So the reason diving is contraindicated is because of the risk of middle ear infection, not because of an equalization problem. Then the question becomes, how do we keep the water out while still allowing the pressure to be ambient (the same as the water around the diver). Well, that problem has been solved in two different ways. The first is a hood, called the Scuba Queen, which provides an ear cup with equalizing tubes to the regulator second stage.

http://www.gmcscuba.com/ProductInfo.aspx?productid=63011

The single tube needs to be plugged into a drilled hole in the second stage of the regulator. This allows air at the same pressure as the surrounding air (ambient pressure) to enter the air space around the ear. The pressure is then equalized by the air which goes through the tube. This was originally used in double-hose regulators, where the second stage is always dry, so if it is used in a current single hose regulator, care must be taken to keep the second stage dry, but with discipline this can be done.

The second is an ear-equalization dive mask which has ear cups attached to the mask band, and equalization tubes which go to the mask. Equalization in the ear cups occurs automatically as the diver equalizes the pressure in the mask.

http://sporting-goods.pricegrabber....-gear/IST-Pro-ear-divers-mask/m722262176.html

The explanation on the above website is a bit off, so ignore the thought that because the ear cup is dry and warm, you don't need to worry about equalization--if your ear drum (tympanic membrane) is intact, you must equalize as normal. But for those with tubes in their ear(s), the ear canal equalizes automatically because of the hole. If only one ear has the tube, then the other needs to be equalized in the same manner as anyone else would do it.

Now, with this in mind, re-contact the ENT physician and explain these two innovations to him/her, and ask whether there is any other problem, other than water getting into the middle ear, that is causing the doctor to say diving is contraindicated. If not, get one of these products and try it out. I hear that they work quite well.

One other thought--don't even try these plugs discussed above. Vented plugs would allow water to enter the ear canal, and therefore allow it into the middle ear. The above two innovations are the only ones that may work to my knowledge in this case. Also, obviously, concrete has its problems

SeaRat

 

[doctormike]

I just posted this an the Divers with Disabilities threads, but I think it should also be posted here:


SeaRat

Hi, John... thanks for your comments. Those are indeed interesting and possibly useful innovations. The discussion of the anatomy and physics of these devices would be worthy of a thread, as would more serious complications beyond a simple middle ear infection (such as perilymph fistulae, permanent sensorineural hearing loss, etc..).

But rather than start down that road, I do want to reiterate something that I might not have stressed enough before, and which I think might be more relevant to the original question.

Of course, there are workarounds for almost everything. And I certainly don't want to be accused of just telling someone with a disability that they can't do something, when in many cases, what seemed impossible becomes quite possible. A blind mountain climber has summited Everest, and many of us have marveled at the grit, determination and ingenuity of Matt Johnston, who has done open water dives despite quadriplegia and a tracheotomy. And of course, over the Internet, who am I to tell someone not to dive...?

HOWEVER, what we are talking about here is someone who is not currently a diver, picking the one recreational activity which specifically aggravates his underlying medical condition. And we are not just talking about middle ear infections. We are talking about the possibility of a sudden vertiginous attack in a new diver if (or when) one of these clever devices fails.

I assume that the person with the tube is an adult, and can make his own decisions. I also assume that if he is determined to dive, he will be able to find a doctor to sign off on the PADI waiver. For that matter, he might just leave it off the medical history form to begin with, and try one of the solutions that you proposed - that is his right, and presumably that is why advice is being sought here.

But if you ask me, I would worry...



Just my two cents..!

Mike

 

[Web Monkey]

I have a friend who has always wanted to dive and now that I am certified and diving he is extremely jealous!! The problem is that one of his ears has a permanent tube in it. His Eustachian tube instead of going from the ear straight down into the throat, has a "notch" in it where his tube will not drain correctly and allows fluids to build up in the "gully" inside the tube, and he had major ear infections as a child, hence the permanent tube.

Here is the advice from the Doc's Proplug website:

"Diving With a Ruptured Eardrum or Ventilation Tubes"
"Do not dive is the best advice."

Terry