Does fluid in the middle ear rule out being able to clear?

[bluebanded goby]

Hi all, while examining me for something else a couple of days ago, my family doctor said that in looking at my left eardrum he saw evidence of fluid in my middle ear (he said he could see fluid and bubbles). He gave me a prescription for Entex PSE (pseudoephedrine and guaifenesin) and asked me to try to hang in with taking it for a week, preferably two (he knows that I hate pseudoephedrine). He also asked me to skip diving while on it (although he okayed snorkeling with my son this weekend).

Now, when I went in to see him, my ear had seemed a little gummy for a few days, but I could usually make the eardrum pop with a Valsalva maneuver. If the eustachian tube is open enough to clear the ear, isn't it open enough to drain? Thanks for any input.

 

[DocVikingo]

The Eustachian tube's primary function is equalization of air pressures, not draining the middle ear space. It is of relatively small caliber and middle ear fluids can be viscous. Therefore, drainage will be poor.

Regarding the fact that one can still equalize despite the presence of such fluid, remember that techniques like the Valsalva maneuver move air into the middle ear under force. That this can be done wouldn't appear to mean a great deal as far as drainage is concerned.

This is educational only and does not constitute or imply a doctor-patient relationship. It is not medical advice to you or any other individual, and should not be construed as such. Follow your physician's advice.

Best regards.

DocVikingo

 

[adjuster-jd]

I had a similar problem with fluid in my ear and with similar medical treatment (Entex PSE along with steroid nasal spray). I told my doctor I would be diving in a week and he seemed to think that would be ok. Ultimately, the feeling of fluid in my ear seemed to go away, and I did not have any problem equalizing that particular ear. I could, even with the fluid feeling there, still use the valsalva to equalize/pressurize the ear.

I guess the question remains - if you can equalize with the valsalva method, is it safe to dive if you still have a feeling of fluid in the ear? I don' t think I have seen a posting which completely answers this issue..
Any advice Doc?