Perforated ear drums

[zebralfc]

Hello all

I am concerned, please can anyone help.

I have been diving for nearly two years now and am about to become an instructor. For this I took a HSE medical. During the medical it was discovered that I have a perforated ear drum (possibly both). It is believed that this has been the case for many years, possibly since I had grommets as a young child. It was not picked up by my GP prior to my starting to dive and so I have been diving for nearly two years with a perforated ear drum. I have not suffered any problems as a result and the HSE examiner has certified me safe to dive.
Having googled the issue all the information I have found says don't dive with perforated ear drums it is very high risk of serious injury.

Can anyone help please
Debbie

 

[doctormike]

Hello all

I am concerned, please can anyone help.

I have been diving for nearly two years now and am about to become an instructor. For this I took a HSE medical. During the medical it was discovered that I have a perforated ear drum (possibly both). It is believed that this has been the case for many years, possibly since I had grommets as a young child. It was not picked up by my GP prior to my starting to dive and so I have been diving for nearly two years with a perforated ear drum. I have not suffered any problems as a result and the HSE examiner has certified me safe to dive.
Having googled the issue all the information I have found says don't dive with perforated ear drums it is very high risk of serious injury.

Can anyone help please
Debbie

Did you see an ENT doctor for that diagnosis...? I can't imagine diving with a perforation and not knowing it.

What is more likely is that the doctor is seeing the area on the eardrum where the tubes used to be. This is called a "monolayer", and can look like a perforation, even though there is no perforation there. In other cases, part of the eardrum can be severely retracted into a "pocket" which can look like a perforation, and it can be hard to tell the difference, even under the microscope.

Maybe see an ENT doctor before assuming that you have a perforation.

Mike

 

[zebralfc]

Thanks for your response.

No, I have not seen an ENT doctor. The diagnosis was made as I can blow air out through my ear drum. I have been able to do this for as long as I can remember and presumed it was normal. The only thing I have noticed while diving is that I have never felt an ear squeeze or the need to equalise, I just assumed that I was equalising well and often enough.

Debbie

 

[doctormike]

Thanks for your response.

No, I have not seen an ENT doctor. The diagnosis was made as I can blow air out through my ear drum. I have been able to do this for as long as I can remember and presumed it was normal. The only thing I have noticed while diving is that I have never felt an ear squeeze or the need to equalise, I just assumed that I was equalising well and often enough.

Debbie

Well, that confirms that there is a perforation, after all..! That's the only way to be able to do that trick.

I guess you have been somehow keeping enough of a pressure gradient across what might be a small perforation, and haven't stressed the system too much... I wonder what your hearing levels are?

I certainly would see an otologist (ENT doc specializing in ear disease) and get an audiogram (hearing test) as the next step. If you tell me where you are writing from, I might be able to give you a name in your area...

Good luck!

Mike

 

[zebralfc]

I had a hearing test today as well as part of the medical. The hearing was slightly below what it should be but not by much and it has always been this way since childhood. I fully intend to see an ENT doctor and get this sorted out. (I am in the UK by the way).
In the meantime I am really concerned whether I should be diving, what the risks are in real terms etc. I was told today that as I have been diving with the condition and no adverse affects for so long that I was OK to continue. I was also told that the risk would be getting an ear infection from dirty water but that would be treatable with drops.

 

[doctormike]

I had a hearing test today as well as part of the medical. The hearing was slightly below what it should be but not by much and it has always been this way since childhood. I fully intend to see an ENT doctor and get this sorted out. (I am in the UK by the way).
In the meantime I am really concerned whether I should be diving, what the risks are in real terms etc. I was told today that as I have been diving with the condition and no adverse affects for so long that I was OK to continue. I was also told that the risk would be getting an ear infection from dirty water but that would be treatable with drops.

As in most cases, the Devil is in the details... you shouldn't take any sort of advice about this from anyone except an ENT specialist, preferably an otologist. To say that the only risk would be an infection from dirty water that could be treated with drops is an extreme and possibly dangerous oversimplification of the issue.

Of course, the fact that you have been diving with this condition is encouraging, but there isn't much point in guessing for something like this. See the appropriate specialist... feel free to keep us posted! Thanks for writing...

Mike

 

[zebralfc]

Thanks very much for all your help.

 

[gert7to3]

I am surprised that you haven't gotten water into your middle ear and suffered an infection. There are some surgical options where your eardrum could be repaired. My right eardrum was basically destroyed by infections when I was young. A tympanoplasty in 1991 corrected the problem and I have been able to dive since 2002.

An interim measure might be to get a Pro Ear mask. It has earcups which are connected to the front chamber of the mask with tubing. You can equalize the earcups and keep your ears dry.

Swimming Ear Protection Diving Masks ProEar 2000

This is by no means a complete, medically proper solution for your condition. Your perforations sound like they are so small, that they act like Doc's Pro Plugs. The fact that you can keep pressurizing your ears prevents higher pressures at depth from overcoming the surface tension of the water against your (presumably) tiny perforations. I'm still amazed your HSE cleared you to dive.

I have no connection to the Pro Ear mask company. I am just a satisfied user of a product which lets me dive more safely and comfortably.

 

[coldwaterlloyd]

Let me start out by saying I am not a medical professional and my opinion is only my opinion not advice .I have been diving with the same condition for over 20 years . Has not been a problem . I dive-mastered and taught during that period without a problem . I still dive and it does not affect me . I have not encountered infections , reverse blocks , vertigo etc .
Make sure you can equalize effortlessly if you have students under your care and you will be fine. Just my opinion , and a bit of experience with your situation . Dive On

 

[coldwaterlloyd]

By the way , a few drops of rubbing alcohol in the ear prevents a lot of trouble , I always have some in my dive bag .