Ear Problems

[RicHeaD]

Starting diving last year. OW in October and AOW in November. After my last dive I developed a middle ear infection. It was treated and at the time the doctor said it looked like a allergy reaction. Last weekend the other ear acted up with a outer ear infection. I have not been in the water since November. I've never had a problem with my ears until now. Can a allergy be causing my problems or do I need to use something to clear the texas lake waters from my ears. Any help would be a plus.

Thank Richard

 

[Rick Murchison]

I'm not an ENT and I haven't run a culture or looked in your ears, so I can't - and am not qualified - to answer your question "spot-on"... But I will offer the "this is what I do to avoid the problem."
Especially when diving in fresh water, after every dive I flush my ears with a "homebrew" composed of half 91% isopropyl alcohol (available at most drug stores), a quarter vinegar and a quarter hydrogen peroxide. Lots of folks use half and half vinegar and alcohol. The Navy uses a mix called "otic domeboro."
Bottom line is that there are critters, plants and fungi in water that can live quite happily in your ear canal, so flushing them out before they can get a foothold is prudent.
Once you have the earache, it's best to see the doc.
Good luck.
Rick

 

[RicHeaD]

Thanks for the info Rick. I've never heard of a ear problem being caused by a allergy reaction when to my knowledge I've never had a allergy before. I was just curious if anyone had this problem or had heard of it before.

 

[BillP]

Hi Richard:

Middle ear infections are often associated with the eustachian tube. The eustachian tube connects your throat with the middle ear so you can equalize the air pressure in the middle ear with the environment. If the eustachian tube becomes obstructed due to swelling from allergies, a cold, or other cause, the middle ear can become infected. Divers, especially new divers, frequently suffer middle ear barotrauma because they have trouble equalizing. This can also lead to a middle ear infection- even in the absence of allergies, a cold, etc.

Outer ear canal inflammation or infections are an entirely different matter. They are often associated with diving (swimmer's ear) and Rick's homebrew preventative looks good. (Last I heard, the prescription Otic Domeboro is off the market.) As Rick said, the drops aren't really for treating a problem, but are instead a preventative measure. There are other causes for outer ear infections (like cleaning the ears with a paperclip) that are completely unrelated to swimmer's ear, but until it clears up it would likely prevent diving.

HTH,

Bill

The above is intended for discussion purposes only and is not meant as specific medical advice for any individual. Questions concerning diving and medical conditions should always be discussed between the diver and their personal physician and/or DAN.

 

[devjr]

This is a very common problem, especially diving in lakes and quarries.

It is due to bacterial infection. Use the homebrew remedy after diving and see a doctor.

Susceptibility is probably inherited and may be related to the size of the ear canals and condition of the earwax. If this wax is easily washed out, the outer ear is vulnerable.

Similarly, some people are prone to inner ear infections, even into adulthood. I'm not sure why but your doctor could advise. The likely cause in this case is the same, contaminated water entering the inner ear canal.

 

[RicHeaD]

Thank You to all who replied. I will try Rick's ear flush with my next dive. The doc has me on drops now. The swelling is dropping as well as the pain. I hope it's over soon. Thanks again to all

Richard

 

[BillP]

Originally posted by devjr
The likely cause in this case is the same, contaminated water entering the inner ear canal.

That's interesting devjr. Can you explain that statement further? For instance, how does the water get into the "inner ear canal" to cause the problem?

 

[devjr]

Water entering through the nose is the main route. If the diver inclines his head upward, especially while clearing, a small amount of water or mucus can be injected into the ear. If the water is fresh, the event may be unnoticed or misinterpreted.

OTOH, if the problem is a perforated drum, it's more likely the diver will react and seek treatment, irrespective of infection.

 

[BillP]

Thanks devjr. That really is interesting. I had heard the thought about mucus refluxing into the eustachian tubes being a factor in middle ear infections before, but never the water injections you describe as being the etiology of inner ear infections nor the idea about fresh water injections going unnoticed.

Do you have references to show us the source of this idea of injected water being the source of "inner ear" infections, or did you develop the theory yourself? Do you have statistics on how often the flora found in contaminated water are found on cultures for ear infections as opposed to normal respiratory flora or typical respiratory pathogens being the etiology?

You're right, if the contaminated water enters the middle ear through a perforated eardrum (the mechanism that I was previously cognizant of) then I would certainly hope that the diver seeks medical attention.

(For those readers of this thread who aren't familiar with the anatomy of the ear, look at the link to Scubadoc's site below. His diagram doesn't mention an "inner ear canal" and I'm not acquainted with that particular part of the anatomy either, so maybe devjr will be good enough to clarify what he's talking about for us. Perhaps it's known by another term?)

http://www.scuba-doc.com/entprobs.html

 

[devjr]

Ear canal; I was referring to the outer ear canal, not the eustachian tube or inner ear.

The presence of fresh water or mucus in the inner ear might be misinterpreted as harmless "water in the ear" or "stuffiness", and ignored. However, by comparison, if this happens with salt water, eg entering through the eustachian tube, the burning sensation is not likely to be ignored. It's usually self correcting in a few hours with no lasting harm, that is, unless there is swelling leading to closure of the tube.

I haven't been hoarding any statistics on this and don't know how wide spread this is. It may be rare. However, the presence of water borne bacteria in the inner ear might suggest subsequent problems with infection; and water does enter the inner ear of some divers under the right circumstances.

No offense, but there are a lot of things that happen out there that divers may not be in a position to analyze or interpret and if these small events are not reported accurately and systematically the medical community may view the occasional complaints as not forming a particular pattern other than that for which they have been trained to diagnose in the (non diving) community.

My suggestion to the subject poster was intended to raise a flag, no more. If the time line of events is wrong or if there was no smoking gun such as "water in the ear" then the theory has been considered and discarded for his particular problem. For purposes of this discussion, we might be allowed the satisfaction that we have discussed the mundane, the possible and the improbable, but not the impossible.

All this futzing around is interesting or boring depending on the reader. However, the subject poster might find it a bit frustrating unless it points to something of practical benefit. However, the presumed purpose of this board is entertainment, exchanging technical information, advice and anecdotes. In the medical area of the board there are special constraints for obvious reasons. For example, the roles and limitations depend on the poster's profession.. A good Samaritan is one thing but an internet Samaritan is in an awkward position. Legally and ethically, how can one assist beyond exchanging information of a general nature and offering sympathetic words? Actually, that's a lot. About all we can offer are our thanks.
D