History of perforated eardrum and trouble equalizing

[Jinglebells0518]

My fiance and I just finished our open water diving class. About 8 years ago he perforated his eardrum. It has since fully healed but he has had lasting tinnitus.

When we were doing our open water dives he had trouble equalizing in the ear that he perforated (not positive they are related but seems likely). He is able to if we descend VERY slowly but he ends up with a headache for hours after the dive anyways and still mild pain throughout the dive. Our instructor told us he'd probably have to learn to equalize faster if we went on any group dives so they wouldn't have to wait on him and he probably will hit a point thay he can't go deeper (we went about 25 feet on our dives).

Are there any other tricks to help him more easily equalize? I've heard some doctors recommend earplugs but not sure the science behind that. Is it likely because of his ear history that he has trouble? Will this prevent him from being able to do deeper dives in the future?

Thanks for the tips and advice!

 

[happy-diver]

Hi have you guys considered jumping in your local diving pool
and doing some equalising with just your masks and snorkels.

sounds like fun to me

whilst you're in the process of getting a sinus check




You've heard wrong about the earplugs

 

[Doctorfish]

If there is tinnitus and the equalization issue is limited to the same ear, there might be other issues than just the previous perforation. Perforation alone should not cause tinnitus 8 years after the event. He might want to see a local knowledgable ENT before continuing to try to dive, experiencing pain, and potentially doing more damage to that ear. Earplugs won't fix this problem.

 

[Jack Hammer]

In general, Many newer divers wait too long to begin equalizing then over-compensate by forcing it. I've seen quite a few people come up with nose bleeds and headaches from doing this. Try to equalize constantly, every few feet, while descending as opposed to waiting til pressure builds up then equalizing. Basically stay ahead of it.

As mentioned, it is best to talk to a specialist familiar with diving to make sure there isn't something else going on.

 

[happy-diver]

Jingle's all away

 

[scubaozy]

Perforated eardrum alone is not a serious problem, it usually heals on its own without permanent damage. If he had tinnitus that is lasting after that incident, it could be that he had a trauma in inner ear which is more serious. He should have been cleared fit to dive by an ENT specialist before diving again. Headache is usually related to sinus problems and indicates there could be congestion due cold or allergies. Eearplugs (Doc proplugs to be more specific) are to protect outer ear, will not help with equalizing.
-Verify with your instructor that he understands equalization techniques and is able to use them at will
-Check with ENT specialist whether he has any prior damage to inner ear
-Make sure he does not dive with a cold congestion or active allergies

 

[MysteriousFathomsBelow]

I had a perforated eardrum at about 8 years old that’s affected my hearing and pretty much everything ear-related since. My first several dives, I didn’t take a single breath without equalizing forcibly by pinching my nose and blowing out.

Breathe in. Equalize ear. Breathe out. Repeat.

After about 4 dives like that, my ears started to do it without being forced - when I swallowed or stretched my jaw. I still made sure to listen for it constantly, making sure I was equalizing as I went. Forcibly via nose, if needed.

It seemed my ears started to get used to it. As long as I’m diving regularly they have acclimated to the feeling of changing pressure and I don’t have to force the equalization. If he hurts, I think he’s still going down too fast. I don’t hurt if I do it correctly. Good luck!

 

[Duke Dive Medicine]

I had a perforated eardrum at about 8 years old that’s affected my hearing and pretty much everything ear-related since. My first several dives, I didn’t take a single breath without equalizing forcibly by pinching my nose and blowing out.

Breathe in. Equalize ear. Breathe out. Repeat.

After about 4 dives like that, my ears started to do it without being forced - when I swallowed or stretched my jaw. I still made sure to listen for it constantly, making sure I was equalizing as I went. Forcibly via nose, if needed.

It seemed my ears started to get used to it. As long as I’m diving regularly they have acclimated to the feeling of changing pressure and I don’t have to force the equalization. If he hurts, I think he’s still going down too fast. I don’t hurt if I do it correctly. Good luck!

Depending on what you mean by "forcibly", you may be putting yourself at risk of inner ear barotrauma. Forcing a Valsalva maneuver can rapidly add an excessive amount of air to the middle ear via the Eustachian tube, which causes the tympanic membrane (eardrum) to bow outward. The ossicular chain (the three tiny bones in the middle ear) is connected to the tympanic membrane at one end and the oval window (a structure on the inner ear apparatus) at the other. If the TM is forced outward rapidly, the stapes (the last bone in the ossicular chain) can exert excessive pulling force on the oval window and damage it or other delicate structures in the inner ear. Equalize early and often. If you find yourself having to force the Valsalva maneuver, it means you have descended too much without equalizing. Ascend, equalize, then descend again.

Best regards,
DDM

 

[MysteriousFathomsBelow]

Depending on what you mean by "forcibly", you may be putting yourself at risk of inner ear barotrauma. Forcing a Valsalva maneuver can rapidly add an excessive amount of air to the middle ear via the Eustachian tube, which causes the tympanic membrane (eardrum) to bow outward. The ossicular chain (the three tiny bones in the middle ear) is connected to the tympanic membrane at one end and the oval window (a structure on the inner ear apparatus) at the other. If the TM is forced outward rapidly, the stapes (the last bone in the ossicular chain) can exert excessive pulling force on the oval window and damage it or other delicate structures in the inner ear. Equalize early and often. If you find yourself having to force the Valsalva maneuver, it means you have descended too much without equalizing. Ascend, equalize, then descend again.

Best regards,
DDM

I’m glad you said this because I don’t want anyone to hurt themselves based on my experience.

I do have to do this even when I go down to the bottom of a 5’ pool and every time I fly. Actually, scuba is the first time since I damaged it at around 4 or 5 years old that I’ve ever noticed it equalize on its own. So maybe my ears are beyond repair?

 

[Duke Dive Medicine]

I’m glad you said this because I don’t want anyone to hurt themselves based on my experience.

I do have to do this even when I go down to the bottom of a 5’ pool and every time I fly. Actually, scuba is the first time since I damaged it at around 4 or 5 years old that I’ve ever noticed it equalize on its own. So maybe my ears are beyond repair?

Not necessarily. An ENT physician would be able to tell you more, I'd recommend you find a good ENT in your area and tell him/her what you've written here.