Ear trauma

[Rj516]

Hello scubaboard community,
I am not diving but i have experienced similar ear barotrauma symptoms that divers get, i have developed tinnitus and decreased hearing after painful ear syringing at a doctor even though my eardrum is intact, do you think it goes away over time? It has been 2 months and tinnitus is better compared to first day, thanks for responses in advance.

 

[Angelo Farina]

Hello scubaboard community,
I am not diving but i have experienced similar ear barotrauma symptoms that divers get, i have developed tinnitus and decreased hearing after painful ear syringing at a doctor even though my eardrum is intact, do you think it goes away over time? It has been 2 months and tinnitus is better compared to first day, thanks for responses in advance.

Impossible to forecast your case evolution remotely.
You need to see a doctor who understands a barothrauma.
What was the cause of the accident?
What you call "syringing at a doctor"?
Do you mean a paramedical procedure for cleaning your ear ducts by injecting water in it?
Of course, if water was injected with excessive pressure, this could have caused a barothrauma.
But the procedure was probably done for fixing some other pre--existing problems, which could also be related to your symptoms.
So, only your doctor has all the knowledge for managing your case.

 

[Duke Dive Medicine]

Hello scubaboard community,
I am not diving but i have experienced similar ear barotrauma symptoms that divers get, i have developed tinnitus and decreased hearing after painful ear syringing at a doctor even though my eardrum is intact, do you think it goes away over time? It has been 2 months and tinnitus is better compared to first day, thanks for responses in advance.

Hi @Rj516 , I would echo @Angelo Farina 's question. I'm not familiar with the term ear syringing, can you explain what you mean by this?

Best regards,
DDM

 

[Rj516]

Hi @Rj516 , I would echo @Angelo Farina 's question. I'm not familiar with the term ear syringing, can you explain what you mean by this?

Best regards,
DDM

Hi,
I meant ear irrigation (by squirting water with a rinsing syringe) to remove earwax blockage, and no, earwax was not affecting my hearing before the procedure, so it was not fully blocked. I felt overpressure during the procedure (it was painful) and since then i have tinnitus and muffled hearing ,3 weeks after ear irrigation i have visited an ENT too, he did tympanometry (normal values), audiometry (10db at all frequencies for air conduction and 5db at all frequencies for bone conduction) and checked with an otoscope, however nothing was visible, so its unexplainable, maybe i was a bit late to visit a doctor after my symptoms started. after reading about barotrauma that happens to divers, my symptoms look similar.

 

[Duke Dive Medicine]

Hi,
I meant ear irrigation (by squirting water with a rinsing syringe) to remove earwax blockage, and no, earwax was not affecting my hearing before the procedure, so it was not fully blocked. I felt overpressure during the procedure (it was painful) and since then i have tinnitus and muffled hearing ,3 weeks after ear irrigation i have visited an ENT too, he did tympanometry (normal values), audiometry (10db at all frequencies for air conduction and 5db at all frequencies for bone conduction) and checked with an otoscope, however nothing was visible, so its unexplainable, maybe i was a bit late to visit a doctor after my symptoms started. after reading about barotrauma that happens to divers, my symptoms look similar

Given your description your symptoms are consistent with inner ear barotrauma but I'm not sure how to interpret your audiogram results the way you've presented them. If you're only able to hear at 10 db air / 5 db bone for all frequencies this would suggest profound sensorineural hearing loss. @doctormike ?

Best regards,
DDM

 

[doctormike]

Given your description your symptoms are consistent with inner ear barotrauma but I'm not sure how to interpret your audiogram results the way you've presented them. If you're only able to hear at 10 db air / 5 db bone for all frequencies this would suggest profound sensorineural hearing loss. @doctormike ?

Best regards,
DDM

Sorry, just seeing this!

No, those are normal values. The thresholds are how loud sound has to be for you to hear it (in decibels), so the bigger the number, the worse the hearing. The "air-bone gap" is the difference between the air line and the bone line. Normally they are the same or close (as in this case). If they aren't, that's an ABG indicates a conductive hearing loss, where the inner ear is working fine but there is something (usually middle ear fluid) causing a hearing loss when tested with headphones (air line).

With a pure SNHL, you would have no air-bone gap but both numbers would be elevated (written as lower on the chart by convention). WIth a pure CHL, you would have a normal bone line but an elevated air line. And you can also have a mixed hearing loss with both.

Typically, hearing loss is scored by the decibel number at each frequency. By one standard critera, moderately severe is 56-70, severe is 71-90, and over 91 is profound.

 

[Duke Dive Medicine]

Sorry, just seeing this!

No, those are normal values. The thresholds are how loud sound has to be for you to hear it (in decibels), so the bigger the number, the worse the hearing. The "air-bone gap" is the difference between the air line and the bone line. Normally they are the same or close (as in this case). If they aren't, that's an ABG indicates a conductive hearing loss, where the inner ear is working fine but there is something (usually middle ear fluid) causing a hearing loss when tested with headphones (air line).

With a pure SNHL, you would have no air-bone gap but both numbers would be elevated (written as lower on the chart by convention). WIth a pure CHL, you would have a normal bone line but an elevated air line. And you can also have a mixed hearing loss with both.

Typically, hearing loss is scored by the decibel number at each frequency. By one standard critera, moderately severe is 56-70, severe is 71-90, and over 91 is profound.

View attachment 826950

Thanks Mike! I'm used to seeing audiogram results in a range so wasn't sure how to interpret that. Appreciate your expertise!

 

[Rj516]

Sorry, just seeing this!

No, those are normal values. The thresholds are how loud sound has to be for you to hear it (in decibels), so the bigger the number, the worse the hearing. The "air-bone gap" is the difference between the air line and the bone line. Normally they are the same or close (as in this case). If they aren't, that's an ABG indicates a conductive hearing loss, where the inner ear is working fine but there is something (usually middle ear fluid) causing a hearing loss when tested with headphones (air line).

With a pure SNHL, you would have no air-bone gap but both numbers would be elevated (written as lower on the chart by convention). WIth a pure CHL, you would have a normal bone line but an elevated air line. And you can also have a mixed hearing loss with both.

Typically, hearing loss is scored by the decibel number at each frequency. By one standard critera, moderately severe is 56-70, severe is 71-90, and over 91 is profound.

View attachment 826950

thank you doctor mike for the information, but what do you think about my case, now it has been 5 months and i still feel like sounds are distant and i have tinnitus after that ear irrigation/syringing/rinsing, how is it possible that i developed all of that without even a eardrum perforation, what is the mechanism behind that?

 

[doctormike]

thank you doctor mike for the information, but what do you think about my case, now it has been 5 months and i still feel like sounds are distant and i have tinnitus after that ear irrigation/syringing/rinsing, how is it possible that i developed all of that without even a eardrum perforation, what is the mechanism behind that?

Sorry, I really can't tell you much more without seeing you, and even then it's unlikely that I would find anything to "fix". Not much is known about tinnitus - the cause or the treatment. Did you see anyone else after the last audiogram?

 

[Rj516]

Sorry, I really can't tell you much more without seeing you, and even then it's unlikely that I would find anything to "fix". Not much is known about tinnitus - the cause or the treatment. Did you see anyone else after the last audiogram?

yes i have seen 2 ENT doctors, they checked with an otoscope did tympanometry, audiometry , then they couldnt find anything wrong (one of them just said ear irrigation is about outer ear and it cant affect inner ear without perforating eardrum, and the another one said it can be sensation), however i dont think that they were knowledgeable about barotraumas as much as you , so i wanted to ask you about that, my symptoms were ear pain that lasted at least 2 weeks after ear rinsing with a syringe (i was feeling pain during rinsing but the nurse didnt care and didnt decrease the pressure), especially when i was sleeping on my ears ear pain was increasing, tinnitus, distant/muffled hearing, ear fullness even though audiogram doesnt show anything serious, i dont really know if my hearing was better than 10db before ear irrigation but i think in that case it would affect the higher frequencies first . so my audiogram wouldnt be the same at all frequencies. i cant understand how all of that things can happen without even an eardrum perforation , it is also impossible that all of those things are sensation, just a day before ear irrigation i had no tinnitus, no ear pain etc. everything was very good, i could hear even the most silent things.