I have just applied my three drops of Flumetasone (Locorten-Vioform) for an otitis I picked up after my last certification dives in Jamaica last week. I had seen a local doctor, recommended by the dive school, complaining of a feeling of pressure and pain around, and a sensation of fullness in, the right ear. She prescribed Amoxil (antibiotic) and diclofenac (anti-inflammatory). These seemed to help a lot with the otitis media, but there was a rough couple of days before they took effect.
At home my local OPD diagnosed an external (otitis externa) pseudomonas infection and prescribed the Locorten-Vioform. They found no significant perforation of the tympanum.
The otitis media probably arose from a low-grade tonsilitis that I was unaware of until examined after the fact. The otitis externa infection may have taken advantage of reduced resistance created by the otitis media.
I spent some time researching this online both in Jamaica and since returning to get a handle on what it will mean for my future diving and how to avoid it happening again. The Divers' Alert Network website was the most prolific source -
http://www.diversalertnetwork.org/ and type otitis into the search box. Also Googling [pressure injury otitis] (brackets indicate Google search box, not part of search query) is quite productive.
My conclusions are:
1) I have every reason to be optimistic that I can resume diving when things have cleared up.
2) Ear wax, within reason, is a good thing - it deters infective organisms that are already present in the ear or arrive with water by providiong a physical barrier and a low pH (acidic) environment that inhibits organisms getting a foothold.
3) Proprietary ear drops and home brews for use after swimming and diving work as substitutes for washed out wax, preventing infection by reducing the pH (with acetic and boric acids) and providing a temporary oily barrier (glycerol etc.) until the wax layer replaces itself.
4) The above drops are purely preventative - they have no effect once infection has a toe-hold.
5) Personally I will be buying some proprietary drops - both because they will at least at first be sterile and, if anything goes wrong I'll have a big firm to sue - and will apply them after every dive/snorkel/swim.
These are just the results of my amateur researches and obviously do not constitute any kind of authoritative medical opinion.
Cheers,
K.