Help!!! Dive Buddy has ear problems

[shakeybrainsurgeon]

It does sound a little premature to consider the situation irreversible, either as regards hearing loss or the future diving.

 

[shakeybrainsurgeon]

After a little net surfing, I found that there is a syndrome known as spontaneous hearing loss or SHL...it occurs in younger people in one ear over a several hour to several day time scale. No cause has ever been identified, although leading speculation is viral. The interesting thing is that over 2/3 recover in 2 to 3 weeks, 1/3 to normal, 1/3 to functional but impaired, 1/3 no recovery. Only steroids seem to help, but carbogen (the CO2 treatment) may help as well, but is less established,

If this is the diagnosis, then there is hope for both recovery and future diving perhaps.

 

[KerriHMI]

Thank you so much, he is seeing a consultant as we speak so I just hope they let him home.

 

[brama2377]

As posted by others, it sounds like your friend has a viral infection, middle ear trauma, or worst case an inner ear barotrauma. I have read extensively on these diseases, as I am a physician that has inner ear barotrauma (nearly complete loss of hearing along with a sense of fullness (need to equalize) in my left ear. During "that" dive, I never recalled any difficulty equalizing either. However, idid get a headache, mild vertigo, and nausea. All resolved wihtin 2 hours except for a mild headache and a new addition of pressure in the ear and difficulty hearing. This pressure and loss of hearing continued to slowly progress over the next 5-6 days (where I am now).

You friend needs:
A formal hearing (audiology test) done in a soundproof booth by an audiologist. Bedside tests wiht tunning fork are not reliable. If the test shows he has conductive hearing loss, it is an eardrum or middle ear problem and nearly 100% reversible. If he has sensi-neural hearing loss, it is his cochlea (most likely rupture of the round window with creation of a perilymphatic fistula) and the hearing and sense of fullness are most likely permanent. If he has vertigo, that is often treatable with surgery.

There is no definitive test for the perilymphatic fistula. However, sensineural hearing loss after diving is due to hemorrhage into the cochlea and or rupture of the round window.
Treatment is as follows:
1. Strict bed rest for 7-10 days
2. Steroids may or may not help but are often tried
3. Keep the head of the bed elevated at 30%
4. Diuretics
5. AVOID STRAINING...during bowel movements and no lifting (hence he strict bed rest.)
DO NOT ATTEMPT TO EQUALIZE THE EARS!!!!!!!!

I have never read anything about CO2 Treatment. However, shakybrainsurg is correct. Increasing CO2 levels will increase cerevral blood flow. One of the theories (unproven) of the pathophysiology of this injury is reduced blood flow to the cochlea. So the CO2 probabaly won't hurt, unless it cause increased production of endolymph, which it may.


If his hearing is getting worse and or not improved after 10 days, he should consider surgery to put a graft (fat, perichondrium, or fascia) over teh round and oval windows. This often helps with vertigo and the sense of fullness, but not the hearing loss.

If it is a conductive hearing loss, teh steroids will help, but he may need antiobiotics.

The KEY is a FORMAL HEARING TEST

IF you or your frind wishes to contact me, I sent you my number via private message.

Note, the above is not medical advice since I do not intimately know the case or your patient. Nor have I examined your friend. Consider it only as friendly advice.

Lets hope your friend improves

Cheers

 

[brama2377]

i can't figure out how to private message you. email me at poogo@hotmail.com

 

[inetmug]

What were the ear drops?

 

[inetmug]

I got a bad case of vertigo on my last dive on ascent. The water was colder than normal. I have only experience it while coming up in shallow water previously. I got a hearing test in the booth and was told everything was fine. However I also was told I had some negative pressure and my tubes were not working right - but that could change by the minute. Prednozone seemed to help as nasonnex. ENT said I need to get deviated septum surguy and the "may" help (but he was very positive). I can clear normally and have done so over the years. When the verigo hits, it stops immediatly upon surface and ENT says tubes are not working right and I get a pressure un-equalization between ears.

What bugs me is the amount of posts that show all this damage when you can clear. I clear often going down and normally have no issues.

What about that pro-ear system?

As posted by others, it sounds like your friend has a viral infection, middle ear trauma, or worst case an inner ear barotrauma. I have read extensively on these diseases, as I am a physician that has inner ear barotrauma (nearly complete loss of hearing along with a sense of fullness (need to equalize) in my left ear. During "that" dive, I never recalled any difficulty equalizing either. However, idid get a headache, mild vertigo, and nausea. All resolved wihtin 2 hours except for a mild headache and a new addition of pressure in the ear and difficulty hearing. This pressure and loss of hearing continued to slowly progress over the next 5-6 days (where I am now).

You friend needs:
A formal hearing (audiology test) done in a soundproof booth by an audiologist. Bedside tests wiht tunning fork are not reliable. If the test shows he has conductive hearing loss, it is an eardrum or middle ear problem and nearly 100% reversible. If he has sensi-neural hearing loss, it is his cochlea (most likely rupture of the round window with creation of a perilymphatic fistula) and the hearing and sense of fullness are most likely permanent. If he has vertigo, that is often treatable with surgery.

There is no definitive test for the perilymphatic fistula. However, sensineural hearing loss after diving is due to hemorrhage into the cochlea and or rupture of the round window.
Treatment is as follows:
1. Strict bed rest for 7-10 days
2. Steroids may or may not help but are often tried
3. Keep the head of the bed elevated at 30%
4. Diuretics
5. AVOID STRAINING...during bowel movements and no lifting (hence he strict bed rest.)
DO NOT ATTEMPT TO EQUALIZE THE EARS!!!!!!!!

I have never read anything about CO2 Treatment. However, shakybrainsurg is correct. Increasing CO2 levels will increase cerevral blood flow. One of the theories (unproven) of the pathophysiology of this injury is reduced blood flow to the cochlea. So the CO2 probabaly won't hurt, unless it cause increased production of endolymph, which it may.


If his hearing is getting worse and or not improved after 10 days, he should consider surgery to put a graft (fat, perichondrium, or fascia) over teh round and oval windows. This often helps with vertigo and the sense of fullness, but not the hearing loss.

If it is a conductive hearing loss, teh steroids will help, but he may need antiobiotics.

The KEY is a FORMAL HEARING TEST

IF you or your frind wishes to contact me, I sent you my number via private message.

Note, the above is not medical advice since I do not intimately know the case or your patient. Nor have I examined your friend. Consider it only as friendly advice.

Lets hope your friend improves

Cheers

 

[KerriHMI]

Thankfully his hearing has recovered completely. The Dr's still have not offered usany explanation. They are sticking with the diagnosis of sensoneural hearing loss. All I know is that when he got home and followed the advice given by DAN and on this board his hearing began to improve.

We went for our first dive post ear problems yesterday and everything was 100% (for him at least, I got stung by a jellyfish, typical!!!). So much for the ENT consultant telling him he would never dive again!!!!

We're just being cautious with regards descending, equalising and ascending, he's also wearing ear plugs at band practice in case that had anything to do with it.