Inner Ear Barotrauma - seeking opinions

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Duke Dive Medicine

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Regardless of the exact physiological mechanism, I'd boil my incident statement down to this:

"Student performed a CESA in the middle of Open Water dive #4. After resting on the surface for a very brief time (< 30 sec), on subsequent descent, the student reported experiencing a mental fogginess and dreamlike/euphoric state, and hearing "tones" in his right ear. The "mental fogginess" lead to the student botching equalization on the descent, with a forced Valsalva maneuver, and subsequently suffering inner ear barotrauma (as diagnosed by an ENT 4 days post-incident.) The student lost nearly 100% of his hearing in the right ear; ~2 months post-incident, the student has recovered ~50% of his hearing, with some persistent hearing loss and tinnitus. Treatment consisted of prednisone (oral steroids), 9 intratympanic steroids, and hyperbaric oxygen treatments."

I hope that is of some benefit to other divers. (I've reported this to both PADI and DAN.)

Ken, I'm going to recommend merging the thread you started for the same issue in mid-March with this one so information can be consolidated.

Best regards,
DDM
 
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I reported the hearing loss the day of the dive (Sunday) and every day after the dive, until our departure from the resort on Wednesday. I was continuously advised by the resort dive shop that it was "nothing, just a routine injury" and that it would clear up on its own. It was out of my own abundance of caution (and my wife's concern) that I scheduled an appointment with an ENT immediately upon my return to the US.

The resort followed up with me a week later, and I informed them about the seriousness of my injury at that time. I also reported the incident to PADI at that time as well (mid-February.)

How is everything Ken? Its been awhile since your injury and am curious on what kind of recovery you made.
 
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Ken Fischer

Ken Fischer

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Thank you for asking. Feb 16 will be exactly 1 year from my accident on 2/16/2020.

My audiogram (latest attached) is largely unchanged from March/April 2020. But, the good news is that in day-to-day living, I am perceiving sounds as clearer and less distorted. I interpret this as my brain adapting to the "broken sensor" in my right inner ear. I have a small bit of tinnitus as well, which is typically only a problem at bedtime when the room is completely quiet. I have a fan on my nightstand that I run at night, to drown it out.

I do still believe I had a nitrogen build-up. The short "at the limits" break between 60' Dive 3 and 30' Dive 4, and the "bounce dive" within dive 4 as a result of the CESA exercise. All that lead to me slipping into a bizarre, dreamlike state on the 2nd descent in the middle of dive 4, which is why the equalization was botched. Also, that evening I was completely wiped out - I slept some 12 hours the night after the dive incident. I passed all of this along to DAN - hopefully it helps others avoid this injury.

Cheers,
Ken
 

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Ken Fischer

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Hey there, I got some problems with my ear too. How is the diving now going for you?

I had an acute injury to my inner ear during my first and only weekend of diving (Feb 15-16 2020.) So, I don’t have any practical advice to give on diving after an injury like mine.

You’d have to provide more details on your specific problems to get good advice. Based on what you’ve said, all I can offer is that there are videos on YouTube about equalization techniques.
 
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