Hearing loss after diving: help needed/anything else that can be done?

[scubaguy532]

Hi everyone, I have been lurking on these forums for a while but this is my first time posting. About 10 days ago I went on 2 boat dives. The first dive I descended to about 80 ft and felt slight pressure as I was on my way down. Not wanting to force anything, I took my time and was eventually able to equalize to the bottom. Immediately after the first dive I noticed fullness and muffled hearing in my right ear. I brushed it off as water trapped in my ear from the hood I was wearing. The second dive was uneventful with no issues equalizing.

A few days later I still had almost *complete* hearing loss in my right ear along with ringing/tinnitus. I called DAN and they assured me it is most likely middle ear barotrauma and will resolve itself with time. I then saw my ENT who gave me a different diagnosis: no fluid trapped in my middle ear as a sign of barotrauma, but instead sensorineural hearing loss as a result of nerve damage in the inner ear. This was not what I was expecting to hear, especially as the pressure I felt on the first descent was not significant enough to concern me. It also surprised me because I never had any dizziness or vertigo which are both listed as main symptoms of trauma to the inner ear/cochlea. Looking back, however, I probably did not equalize early and often enough on that first descent.

Nevertheless, he prescribed me a full dose of oral steroids which I am currently taking and advised that if the hearing does not come back, I should not dive again to avoid risking hearing loss in my other ear. This was obviously a total gut punch to hear and I'm trying not to get depressed about it.

I am seeing another ENT/neurotologist on Friday who is well versed in diving knowledge. I am not sure he will tell me anything different but I am praying there is a path forward both in terms of restoring my hearing in my right ear and being able to dive again. I have read some reports of hyperbaric oxygen therapy as a solution to this issue (Sudden hearing loss causes scare for diver) as well as another poster who experienced a similar issue and got their hearing back after the steroids (Question - Full ear/hearing loss but can equalize fine?). The ENT I saw said that oxygen therapy is a type of fringe medicine used mainly for DCS and would not help in my case.

Has anyone else experienced/heard of complete hearing loss in one ear after diving and know any other possible solutions? From what I have seen/read it is very rare to have a complete loss of hearing, rather than partial hearing loss associated with barotrauma. The thought of never diving again is one that I could barely fathom to imagine and I'm praying there will be a positive outcome to this situation. Thanks.

 

[John C. Ratliff]

You might want to post your dive profiles for both dives, and the surface interval too. Better yet, a computer printout of the dive profiles would be helpful.

I say that because this appears to possibly be a decompression illness (bends) situation, and not barotrauma.

SeaRat

 

[scubaguy532]

You might want to post your dive profiles for both dives, and the surface interval too. Better yet, a computer printout of the dive profiles would be helpful.

I say that because this appears to possible be a decompression illness (bends) situation, and not barotrauma.

SeaRat

Would you be able to share why you think this might be a result of DCS? I did experience pressure on the first descent and likely did not equalize early enough until it was too late. Here are my dive profiles:

Dive 1:
-36 min of bottom time at an avg of 72 ft depth
-Gas: EAN 34%
-50 min total dive time
-Max depth 84 ft

Dive 2:
-1hr 5 min surface interval
-39 min of bottom time at avg 66 ft depth
-Gas: EAN 34%
-total dive time 52 min
-Max depth 79 ft

Please note I never went under 10 minutes of my NDL on either dive and made a slow/steady ascent with a 5 min safety stop. If this is a result of DCS, do you know if I should be approaching it the same way?

 

[happy-diver]

the pressure I felt on the first descent was not significant enough to concern me.

What's this chief

 

[John C. Ratliff]

Scubaguy532,

The reason I’m even thinking of DCS is that you have neuron damage to the inner ear without the barotrauma that should be associated with the loss of hearing. If it were a barotrauma, it would damage the middle ear, or burst the oval or round window to the inner ear. Apparently, you have neither of these injuries. So that leaves DCS.

One thought is that maybe you should get checked out for patent foramen ovale, which is a hole in the heart’s chamber between the left and right sides of the heart. When we are born, this hole is there, but it soon closes as we start using our lungs, in most people. But for a certain portion of the population (I’ve heard, I think from memory, about 20% of the population) this hole doesn’t close. With PFO, a diver is much more prone to experiencing decompression sickness. You can be within the NDL, and experience DCS. This is because micro bubbles which normally go to the lungs and are eliminated instead get into the circulation for the rest of the body, and can go up to the brain and other organs, like the ear.

Patent foramen ovale: A hole in the heart-Patent foramen ovale - Symptoms & causes - Mayo Clinic

Learn more about the causes and complications of this condition in which a hole in the heart doesn't close the way it should after birth.

www.mayoclinic.org

PFO's and Diving - The Diver Clinic

Pfo's and diving - The Diver Clinic, Poole & Reading. NHS funded 24 hour hyperbaric diver advice and decompression illness treatment, 07770 423637

www.thediverclinic.com

This is just a thought, and I’m not a doctor. But I am a long-time diver and have a MSPH degree from Tulane University, worked in industrial hygiene and am a member of the Noise Committee of the American Industrial Hygiene Association. So it is something to think about, and maybe consult your doc about. Also, if this is a potential, it is possible that recompression treatment might help. But that’s up to a hyperbaric doc to decide.

SeaRat

 

[clownfishsydney]

I have had ear problems three times. In all cases the hearing loss resolved itself, not totally, but mostly. The first time I lost some hearing, the second and third times I feel I still have the same hearing as after the first one. In none of the cases did I experience any problems when underwater, only after I exited. The last time was the worst in terms of loss of hearing, almost total, but it was a fair bit better after five hours and back to "normal" after two weeks.

In all cases, the same ear was involved. The time between each event was 10 years and 16 years. I do a lot of diving, over 100 dives a year on average, so I guess I am more likely to suffer some sort of problem than the average person.

 

[Seamore Butt]

Have you been seen by an Audiologist?

 

[scubaguy532]

What's this chief

Like I said, I did feel slight pressure on the first descent just nothing crazy. I was eventually able to equalize. But later on I realized I should not have felt any pressure in the first place should I was able to equalize properly and early enough so I was worried that was my mistake.

 

[scubaguy532]

Thanks, I will ask my doctor about that. The only thing is, I have done over 100 dives and never experienced anything linked to DCS before. And even this time I never experienced any other symptoms of DCS. So that's why I was a bit surprised. But I will ask my doctor about possible recompression therapy if that has even a remote chance of working.

Scubaguy532,

The reason I’m even thinking of DCS is that you have neuron damage to the inner ear without the barotrauma that should be associated with the loss of hearing. If it were a barotrauma, it would damage the middle ear, or burst the oval or round window to the inner ear. Apparently, you have neither of these injuries. So that leaves DCS.

One thought is that maybe you should get checked out for patent foramen ovale, which is a hole in the heart’s chamber between the left and right sides of the heart. When we are born, this hole is there, but it soon closes as we start using our lungs, in most people. But for a certain portion of the population (I’ve heard, I think from memory, about 20% of the population) this hole doesn’t close. With PFO, a diver is much more prone to experiencing decompression sickness. You can be within the NDL, and experience DCS. This is because micro bubbles which normally go to the lungs and are eliminated instead get into the circulation for the rest of the body, and can go up to the brain and other organs, like the ear.

Patent foramen ovale: A hole in the heart-Patent foramen ovale - Symptoms & causes - Mayo Clinic

Learn more about the causes and complications of this condition in which a hole in the heart doesn't close the way it should after birth.

www.mayoclinic.org

PFO's and Diving - The Diver Clinic

Pfo's and diving - The Diver Clinic, Poole & Reading. NHS funded 24 hour hyperbaric diver advice and decompression illness treatment, 07770 423637

www.thediverclinic.com

This is just a thought, and I’m not a doctor. But I am a long-time diver and have a MSPH degree from Tulane University, worked in industrial hygiene and am a member of the Noise Committee of the American Industrial Hygiene Association. So it is something to think about, and maybe consult your doc about. Also, if this is a potential, it is possible that recompression treatment might help. But that’s up to a hyperbaric doc to decide.

SeaRat

 

[scubaguy532]

Have you been seen by an Audiologist?

Yes, and had 2 audiograms, both show next to no hearing frequency in the right ear.