Ear Drum Rupture and Flying

[Jasmine Corbett]

Hi guys - looking for some honest advice on ear drum ruptures.

Have been trawling forums for days, but getting a lot of varied answers, so wanted to check on here if anyone has had a similar experience.

Recently I had a persistent cold, which was then accompanied by middle ear infection. Build up from behind the ear drum caused it to rupture (was not diving but on land).

This happened on 10/11. Since then I have been taking antibiotics, drops, decongestants etc. There is still a lot of stuff coming out of the ear drum but I think the cold has definitely cleared now.

I live in Philippines and the ENT specialist is 7 hours away, so I plan to go back to the UK for a while where I can get free healthcare and ENT specialist that lives in the same town.

I asked the ENT specialist here, and also the local doctor if I can fly, to which they both said yes of course.
Is this true - you can fly with the rupture when there is still discharge behind it?
I plan to fly on either 26/30 of Nov so hopefully the discharge will be cleared by then.

Just wanted to see if anyone has experience with this...how soon did you fly after rupture etc?

Also very open question - but how long should you realistically wait before diving again?
Diving is my life, so I'm happy to wait longer if it means I can dive again without trouble.

Ah and one more thing - I've heard steroid drops help to heal the rupture better - anyone used these before?

Any advice would be HUGELY appreciated. Thanks!

 

[KathyV]

I'm not a doctor but my husband ruptured an ear drum years ago while diving on Bonaire, and he had to stop diving of course, but flying home was not an issue. After it healed he was able to dive again without problems. He can't even remember which ear it was any more.

And we've both had middle ear infections while on dive trips in the past and sought medical advice - for awhile we took turns getting sick on vacation. I now know how to ask for directions to the pharmacy in several languages.

The doctors usually prescribed antibiotics, anti-inflammatory drugs, and decongestants. They said "no more diving until it clears" but they didn't have any concerns that we would be flying home soon - I specifically asked about it, too. The change in pressure during flying was sometimes uncomfortable, but not terrible.

We both got ear infections on the same trip when diving the Red Sea, we went to the hospital and they poured mercurochrome (that nasty red stuff!) into our ears, packed them with cotton, a lot of good that did! I asked about flying and was told it was fine. The long flight home was quite interesting because we were sitting next to each other on the plane and we had to turn our bodies sideways in the plane seats just to be heard by the other person. We didn't talk much during that trip home.

Once my husband had a middle ear infection that took a long time to heal and he saw the ENT several times after we got back from a dive trip. The doctor put tubes in his ear to let them drain. My husband was a skydiver back then and I was certain (to tell the truth I was hoping!) that he would have stop jumping out of planes during the recovery so I asked the doctor about it. He said "no, skydiving is fine, but just don't get it wet."

Again, I'm not a doctor but I think you will be fine flying home. Make sure you see a specialist and follow his advice. If you don't like the doctor, see another one, your hearing is important, good luck!

 

[KathyV]

BTW, neither of us have had ear infections on dive trips for several years. We are diving less now so that is probably an important factor, but we are also taking some advance precautions that seem to help.

We regularly use a nasal inhalant like Flonase during the trip, and we do netipot sinus rinses every night during the trip (we travel with his and hers netipots!) And just for luck, we use ear drops after every dive to dry out the outer ear canal and prevent outer ear infections.

So far this regimen has been working for us (knock on wood!) but the OP dives a lot more frequently than we do, so I don't know if they would be as effective for her - but it probably wouldn't hurt to try because ear infections are no fun at all.

 

[flyboy08]

As long as the aircraft you're flying maintains a cabin pressure of 5-7k feet, you'll be fine. Should the cabin loose pressurization, this might become somewhat painful until the decent reaches about 10K. If the aircraft flies lower than 7k, then no worries at all....

 

[MargaritaMike]

After my last dive trip in October both of my ears have been full of fluid. I went to see an ENT. Tomorrow (11/16/2017) he is correcting a deviated septum, roto-rootering on of my cheek sinuses, and expanding the hole in my Eustachian tubes with balloons. He is making an incision in my ear drums. When asked he said the ear drums should heal in about 3 days. He doesn't want me to fly for 10 days (I think because of the septoplasty and nose bleeds when clearing my ears) and I could go diving in 2 weeks after surgery (assuming no infections or other contraindications).

I would think that flying with the ruptured ear drum would not be a problem because the pressure would equalize itself.

I AM NOT a doctor. Good luck.
Cheers - M²

 

[doctormike]

A truly perforated eardrum completely eliminates any risk of barotrauma while flying. This is true from the second it perforates. However, this diagnosis is often incorrect, even if a doctor has examined the ear.

In a normal ear during air travel, you need to equalize your middle pressure with ambient pressure (slightly lower than atmospheric pressure in commercial aviation), just like you need to equalize your middle ear pressure while diving. The perforation does this for you.

There is no contraindication to flying with a perforated eardrum. If anything, it makes it easier. Kids with ear tubes (controlled perforations) don't have the usual pain on ascent and descent.

Antibiotic/steroid drops are often used for a draining perforation, not to help the eardrum heal but to treat the outer ear inflammation that comes from the drainage. They aren't much use if there is heavy drainage, you need to get the ear cleaned out first, preferably by someone who knows what they are doing, with a microscope and suction.

As far as diving after an eardrum perforation, you should first (1) see an ENT doctor to confirm healing, (2) get a hearing test to make sure that there has been no damage to the middle or inner ear, and (3) make sure that you can equalize easily in a pool or other shallow water.

 

[Jasmine Corbett]

Thank you everyone for your replies so far!

Kathy V - thank you for your tips and reassurance on this. That has really helped and good to know you can fly still with this.
I will look into the nasal inhalant - did you find this helps to use this during the flight also?

Doctor mike - I have some questions about the flying with perforation. Say I fly in 10 days, the mucus has cleared, and the perforation (in best case scenarios) has closed. Would this be painful then due to the perforation being closed, and could this allow the possibility of re rupture?
In another instance, if the perforation is still open, but there is still mucus blocking the back of the ear drum, could this be painful and/or make the rupture worse?

And yes as soon as I get back to the UK I will see a proper specialist and ask for a hearing test. Do you think the fact that I will only get to see a specialist in the UK for proper diagnosis, around 3 weeks after the initial rupture, could mean that the long term effects of the rupture will be longer lasting?

Unfortunately the company I work for is low staffed right now, so they want me to stay longer and be doing office work for a while :/ Im worried that the longer I wait for a better diagnosis, the damage will get worse. Their argument is that I will be healing as much out here, than I would be in the UK.

Sorry if my questions seem a bit clueless - I have never experienced ear infections or perforations before, so my knowledge is limited.

Thanks again for all the information guys.

 

[KathyV]

Thank you everyone for your replies so far!

Kathy V - thank you for your tips and reassurance on this. That has really helped and good to know you can fly still with this.
I will look into the nasal inhalant - did you find this helps to use this during the flight also? ....

I have allergies and am prone to sinus infections and I have also had sinus surgery - and that helped - I think that keeping my head clear is generally helpful with the activities of living, including flying. It is certainly more comfortable.

Your health is the most important thing, don't let your job strong arm you into to doing what you don't feel is the best thing for you. Ask them if they can set you up with a remote connection so that you can work from back home.

 

[doctormike]

Doctor mike - I have some questions about the flying with perforation. Say I fly in 10 days, the mucus has cleared, and the perforation (in best case scenarios) has closed. Would this be painful then due to the perforation being closed, and could this allow the possibility of re rupture?
In another instance, if the perforation is still open, but there is still mucus blocking the back of the ear drum, could this be painful and/or make the rupture worse?.

I can't give you specific advice without knowing what is going on in your ear. Certainly, flying with a cold, ear infection or anything else that compromises your ability to clear your ears will potentially put a strain on your eardrum. The bottom line is that you need to be able to equalize the pressure in your middle ear clefts (the space behind the eardrum) if you fly or dive.

If the perforation is open, the perforation is open, and there will be no pressure differential, so no barotrauma. Unfortunately, it's unlikely that you will get a completely accurate diagnosis if you are far from specialty care.

 

[Jasmine Corbett]

I can't give you specific advice without knowing what is going on in your ear. Certainly, flying with a cold, ear infection or anything else that compromises your ability to clear your ears will potentially put a strain on your eardrum. The bottom line is that you need to be able to equalize the pressure in your middle ear clefts (the space behind the eardrum) if you fly or dive.

If the perforation is open, the perforation is open, and there will be no pressure differential, so no barotrauma. Unfortunately, it's unlikely that you will get a completely accurate diagnosis if you are far from specialty care.

Ok thanks a lot for the information. Kathy V - thanks for your support