Equalizing

[liberato]

...I have a ruptured ear drum. I was wandering if anyone else had gone through this and how long it kept you out of the water? Also how did it effect you on your next dives? Thanks for any info.....

I am surprised that you don't recall the exact event because there is usually great pain right before the occurrence, then relief. The kind of tympanic membrane punctures that commonly occur in diving tend to be small, easily healed tears (as opposed to the devastation that occurs if you are near the shockwave of an explosion, for example. Your ENT doc can tell you the extent of the tear and recovery potential. Have him draw a picture of it for you.

Generally, the least intrusive therapy is best. Let it heal on its own. Each TMP and subsequent rehabilitation is different but assuming it is minor, it can be 1-2 months. In my case there were no lingering complications (full hearing restored, no chronic re-tears) but I can sense a vague feeling of difference in how the two ears feel (probably due to the small amount of scar tissue). It is not a bad feeling, just different.

Though in my case it did not keep me out of the water (ping me with a PM for more details if you absolutely need to be in the water, otherwise, yes, follow the prescrition to stay out), it did make me a better and more careful diver because I now know the consequences of improper technique.

 

[Laurence Stein DDS]

Laurence, thanks for the explanation. How will my situation affect me the next time i dive? Is there a greater chance for it to happen again?

Msange1,

Ditto, liberato. Remember I'm a dentist and only work next-door to the ears.

I've heard of recuperation periods of around 3 months for a perforated ear drum...especially caused by diving. You ENT has the last say and you should be re-examined after the waiting period and BEFORE your scuba dive.

If the perforation is properly healed, there should be no problem and no deficit. However, if there was severe or additional undetected trauma from the original injury only time will tell what the final outcome might be.

Certainly, if you reinjure your ear on the next dive, you should rethink your hobby. The same is true if you experienced a round or oval window perforation.

While it just might have been a fluke, you might also want to examine you equilization technique...it could have been the root cause of your problem and if you're doing it wrong, you may very well repeat the injury.

Good luck to you.

Laurence Stein, DDS

 

[Laurence Stein DDS]

Thanks for the information. I had thought that with barotrauma my ears get swollen. Is that not the case?

Er...I haven't seen your ears....were they like stickin' way out? Don't you hate it when ears get swollen? Kind of looks like an elephant, huh?

As I said before barotrauma is the mechanism by which the injury occurs. It is not the specific injury to a specific location. If there was swelling, it may have been localized or not visible. Swelling could have been completely internal. You ears don't swell up on the outside unless you were swatted in the ear by an irate damsel fish or you were boxing.

Can I have had a slight infection for a long time? What causes an infection? I actually haven't dove since August, and I have never had an infection before.

Actually, you can have a chronic infection. A chronic infection means a long standing, low grade infection. It may or may not cause pain and you may be unaware there is a problem.

I also remember in the weeks before my dives some slight pains in my ear once in a while.

Other times you might notice something but not put "two and two" together and suspect an infection. If you ear seems blocked on day and then went away, you might not pay much attention to it.

You might have had a cold or URI (upper respiratory infection) that blocked you eustacian tubes, and allowed you to collect some fluid in the middle ear. The problem didn't become acute until the dive. Then the potential for a barotrauma injury to the eardrum, middle ear or even the inner ear increased. The injured tissue became a target for the chronic infection you may have had.

It's a gross example but we've all had a "blemish" on our neck or earlobe. (I know I have). Now you've got this red spot and you can't help but play with it. Some of these blemishes simply stay a red spot and finally got away but some of them get real angry with your playing with it and turn into a rip roaring white headed ZIT!—a low grade infection that becomes acute.

What causes an infection? I actually haven't dove since August, and I have never had an infection before.

GERMS cause infections. In most cases, germs refer to bacteria. Diving doesn't cause infections. Your body is covered with germs. On the skin, in your mouth, nose and throat, in your stomach and intestines. In most cases, they don't cause a problem. Many of these bacteria are supposed to be there and are beneficial. On occasion, when the conditions are right, a pathogenic bacterial can take hold and cause an infection. Rarely, some of the "beneficial" bacteria can cause a problem when they get into the wrong areas.

If you were to take a swab from around your nose and culture it, you wouldn't believe the staphlococcus germs that would grow. Culture the external ear canals and you might get pseudomonas. These are pathogens that are just sitting there, waiting for the opportunity to cause an infection.

Your diving may have created the situation for an opportunistic infection to occur. Barotrauma caused an injury which resulted in a tear in the tissues. The bacteria then entered the tear and set up an infection.

The intense pain has gone away with Cipro. Now it still feels muffled (both of my ears) and I do have occasional pangs in my right ear, but it is a milliion times better than before.

If your ears have not returned to normal, don't dive. See your doc again. Muffled sensations and pangs are NOT NORMAL. The antibiotic may have knocked the infection down but may not have eradicated it. Don't assume that just because you took and antibiotic and finished it, you infection is gone...especially if you continue to have symptoms.

It should go without saying...if you have a problem...during or after a dive and you are are concerned about it AND/OR it is not going away. See the doctor. Delaying treatment because you might be waiting for a reply from this or any board is not the way to go. If you are concerned enough to ask the question, then the problem should be seen by your physician. Information you may receive here is often delayed, based on generalities, discussed without the aid of a medical exam or your physician asking the question, discussed between lay and professionals alike and MIGHT BE TOTALLY INACCURATE OR INAPPROPRIATE FOR ANY SPECIFIC PROBLEM.

Hope this helps.

Laurence Stein, DDS

 

[LubaScuba]

Hi all! New to boards and diving. I was recently diving off of Singer Island, Fla. After completing our last dive i had somewhat of a "funny feeling" in my right ear. Since returning home i've been informed by the doc that i have a ruptured ear drum. I was wandering if anyone else had gone through this and how long it kept you out of the water? Also how did it effect you on your next dives? Thanks for any info.....

Ear drum perforation of a smaller size heals quickly (days) but it takes some time (weeks) to develop the same strenght as before. The remaining scaring is usually of no consequence on further diving. In your case one question comes to a mind. Why was it so 'silent'? Some people have eardrums that don't have all layers and such a weakened eardrum might be quite easy to break 'silently'. To check for that your physician may ask you to inflate your middle ear during the otoscopic examination which would eventually reveal 'baloning' of the ear drum. (Of course now is not the time for such examinations as pressure rest is needed to allow healing.) That condition requires special precaution with eventual future diving as not all ear drum ruptures at depth are followed by only "funny feeling". You should consult with diving physician in person for examination and risk evaluation after the eardrum healed.