Otosclerosis

[hubert]

Hi guys,

I have a this ear disease called otosclerosis - the little bones doing the sound transmission from the drum to the inner ear get calcified and move less and less easily (at least, that's my understanding). I now have to wear hearing aids, which somehow spoils my dashing looks!

I have two questions. One is, is there any info about the influence of diving on the disease? Two, a form of surgery is possible where the calcified bones are replaced by a piece of teflon (like in non coating pans). Is it still possible to dive after that?

Any info would be greatly appreciated.

Hubert

 

[DocVikingo]

Hi Hubert,

Otosclerosis is a primarily inherited disorder and progressive. Abnormal growth of sponge-like bone in the middle ear prevents the ear bones (ossicles) from vibrating in response to sound waves. Most commonly, the tiny bone at the end of the ossicular chain, known as the stapes (aka stirrup), becomes frozen in place or "fixed." (A simple diagram of the anatomy of the ear can be found at -- Ear Anatomy Diagram - EnchantedLearning.com).

This condition is not a contraindication to SCUBA providing that the diver can hear well enough underwater to be aware of auditory signals from the DM, boat or a buddy alerting him to an aborted dive, dangerous situation or the like.

SCUBA wouldn't be expected to make the otospongiosis worse, although hearing could be further compromised by routine hazards to the ear inherent in diving such as barotrauma and infection. This could result the otosclerotic diver sustaining even further reduced auditory acuity.

The most common form of surgery for otosclerois is stapedectomy, where the stapes is removed and replaced with a prosthesis. Alternatively, a stapedotomy may be done, where a micro-drill or laser is used to make a hole in the stapes to allow placement of the device. The artificial stapes can be made of a variety of materials, including stainless steel, titanium, Teflon and a graft of the patient's own bone.

As regards diving after implantation of a prosthetic stapes, a study published in Otolaryngology—Head and Neck Surgery (2001 Oct;125(4):356-60), entitled "Diving after stapedectomy: clinical experience and recommendations," concluded: "Stapedectomy does not appear to increase the risk of inner ear barotrauma in scuba and sky divers. These activities may be pursued with relative safety after stapes surgery, provided adequate eustachian tube function has been established."

Helpful?

Happy holidays/Joyeux Noël et une nouvelle année heureuse.

DocVikingo

 

[hubert]

Hi Doc Vikingo,

This is the most useful info I ever got on the topic. Thanks very much - is otolaryingology your field?

Joyeux Noel et bonnes fetes de fin d'annee to you too

Hubert

 

[Gene_Hobbs]

As regards diving after implantation of a prosthetic stapes, a study published in Otolaryngology—Head and Neck Surgery (2001 Oct;125(4):356-60), entitled "Diving after stapedectomy: clinical experience and recommendations," concluded: "Stapedectomy does not appear to increase the risk of inner ear barotrauma in scuba and sky divers. These activities may be pursued with relative safety after stapes surgery, provided adequate eustachian tube function has been established."

And again in 2007:

Huttenbrink KB. Clinical significance of stapedioplasty biomechanics: swimming, diving, flying after stapes surgery. Adv Otorhinolaryngol. 2007;65:146-9. PubMed ID: 17245036

also concluded:
"Flying or diving can be performed by the patients after stapedioplasty, provided that a test with tympanometry is tolerated without evoking vertigo."

 

[slingshot]

I second hubert's question, what is your specialty Doc Vikingo?

 

[evelmer]

I had stapedectomy ear surgery 2 months ago where I had a prosthesis inserted into my stapes bone, and am happy to report that I dove two 60 foot dives with no trouble equalizing. My Dr. just recommended that I use a decongestant before my dive. Happy divings!