otolaryngologists...

[Aigtbootbp]

Not sure if this is the correct forum for this but I can't find anywhere I think this would fit so here it is.
For a person with Menieres disease, would having intralympanic therapy (they stick a needle through your eardrum to inject medicine) preclude someone from diving?
Thanks!

 

[tc]

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A ScubaBoard Staff Message...

Moved to Diving Medicine.

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[cutlass]

I'm not familiar with that procedure but for comparison, IIRC a needle puncture to drain middle ear fluids (tympanicentesis) has healing time ranges from 4-7 days. I believe that a smaller gauge needle (25+ ?) is used as compared to tympanicentesis (20+ ?). One would expect that this helps improve the healing time but there may be other concerns as noted below.

I'm more concerned about your disease. Having Meniere's usually raises serious caution flags for an activity as dynamic as diving. But since it appears that you've already done some diving, I assume you've been cleared to do so and your condition has been controllable and stable. That is, until now. I assume your condition has changed because a procedure is being mentioned. I think that at a minimum, you'd first want to see how you respond to this new treatment before thinking of getting back in the water.

Next, I believe that a steroid (dexamethasone) is one of the injectable options. Steroids tend to impair wound healing. For one thing, this may slightly complicate healing from the procedure itself. For another, I have questions on the durability of the eardrum after repeated treatments.

 

[Aigtbootbp]

Thanks for the reply Cutlass, the menieres is not really much of a problem but more of an annoyance. I was worried about how the hole would heal. If a week should do it then it is worth it. BTW, they use a antibiotic not a steroid. I don't know how any of this works, I am just Joe Scuba, average diver.
Thanks!
Gary

 

[cutlass]

IIRC, the antibiotic is gentamicin.

Again, this isn't my area; we've merely crossed paths a couple of times over the years*. So give no authority to my comments.

Several treatments may be involved with waiting intervals of some weeks between each. There may be restrictions on your activity during this time.

There is one consideration which I expect has already been discussed with you and I mention mainly for other's fyi. Gentamicin basically "kills" the vestibular system in the ear being treated. This leaves balancing duties to the remaining ear. This is significant. If there is future loss of that, not only is normal balance function gone but along with that, vision or walking may be affected; e.g. blurring/"bouncing" vision or unstable/"drunken" gait. This clearly could impact ordinary everyday life activities. Therefore, there must've been good consideration of its benefits and risks and of any possible less drastic alternatives.

*Car accident victims.