hello. I was taking my advanced certification and on the second day after doing our deep dive, we went back down to about 10ft to swim back to shore. I ended up perforating my ear on the way down. i have read that it could have been caused by head colds, and not equalizing properly. The thing is, is that i wasn't sick and i equalize more than anyone probably. It has been almost 3 months now and it has not healed. Is that a good sign or not? I went to a ENT and they said that if it doesn't heal in the next 6 weeks i am going to have to get surgery. will that mean i won't be able to dive again, ever? thank you.:upset:
perforated ear
- Thread starter Sadler99
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Sorry, to hear about your eardrum. I have ruptured one on two occations. Both times it took 2 months to heal. The diving doc should give you an answer soon. Are you going to the ENT to get the eardrum cottorized (sp)? I had to do that every week for both ruptures. Helps with healing and keeping bacteria away. Best of luck.
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Hi Sadler99,
That is too bad.
Most small perforations spontaneously heal in several weeks, but more expansive ones can require 3-6 months. Yours reportedly is nearly at the 3 month mark.
As your ENT has suggested that surgery be performed in 6 more weeks if the hole has not closed by then, I'd say this is a sign that you may undergo it.
In any event, surgical repair of the eardrum (tympanoplasty) does not necessarily mean that one won't be able to dive again. Some divers do return. However, the repair can remain a delicate area subject to re-rupture under such stresses as inadequate or overly vigorous equalizing.
Your ENT should have the final say on eventual return to diving. If he or she does not feel capable of making this call, referral to an ENT with dive medicine training may be appropriate.
This is educational only and does not constitute or imply a doctor-patient relationship. It is not medical advice to you or any other individual, and should not be construed as such. Discuss your concerns with your doctor.
Best of luck.
DocVikingo
That is too bad.
Most small perforations spontaneously heal in several weeks, but more expansive ones can require 3-6 months. Yours reportedly is nearly at the 3 month mark.
As your ENT has suggested that surgery be performed in 6 more weeks if the hole has not closed by then, I'd say this is a sign that you may undergo it.
In any event, surgical repair of the eardrum (tympanoplasty) does not necessarily mean that one won't be able to dive again. Some divers do return. However, the repair can remain a delicate area subject to re-rupture under such stresses as inadequate or overly vigorous equalizing.
Your ENT should have the final say on eventual return to diving. If he or she does not feel capable of making this call, referral to an ENT with dive medicine training may be appropriate.
This is educational only and does not constitute or imply a doctor-patient relationship. It is not medical advice to you or any other individual, and should not be construed as such. Discuss your concerns with your doctor.
Best of luck.
DocVikingo
sadler-
You metion you were "equalizing more than anyone".
Equalizing when not neaded to, might be a problem, aspecialy at shalow depths. You might haveaccidentaly equalized while ascending, without noticing it. Equalizing on ascent is dangerouse, as not only you do not let air go out of your ear, you also push more air inside.
You metion you were "equalizing more than anyone".
Equalizing when not neaded to, might be a problem, aspecialy at shalow depths. You might haveaccidentaly equalized while ascending, without noticing it. Equalizing on ascent is dangerouse, as not only you do not let air go out of your ear, you also push more air inside.
Carlislere~~ thank you for replying back to me. i don't know if they are the same thing, but i don't think i ruptured my ear, just perforated it. The ENT never mentioned anything about the Cottorizing thing you said about. just told me to keep water out. kinda hard when you taking a shower.
Doc~~ thank you for replying back to me. So far my ENT has told me that diving is not completely out of the question, but just for now, which i understand. Do you think, if i am allowed to continue diving, that deep dives should not occur?
Liquid~~ thank you too for replying back to me. i know you said i could have equalized while ascending with out know it, but as far as i know, i only equalized on the way down. when it came time to ascend, just keeping my head up, my ears would equalize (or however you call it for the ascending term) by themselves. i never physically did anything on the way up. don't know. like you said, maybe i did it without knowing. that would be a hard one to determine.
Doc~~ thank you for replying back to me. So far my ENT has told me that diving is not completely out of the question, but just for now, which i understand. Do you think, if i am allowed to continue diving, that deep dives should not occur?
Liquid~~ thank you too for replying back to me. i know you said i could have equalized while ascending with out know it, but as far as i know, i only equalized on the way down. when it came time to ascend, just keeping my head up, my ears would equalize (or however you call it for the ascending term) by themselves. i never physically did anything on the way up. don't know. like you said, maybe i did it without knowing. that would be a hard one to determine.
We have had two students recently who have permanent perforations - in the past this was pretty much considered an absolute contraindication to diving. They both used the Proear mask successfully, and both are now diving regularly with, to my knowledge, no problems.
The Proear website is at http://www.proear2000.com/
Rick (not associated with proear in any way)
The Proear website is at http://www.proear2000.com/
Rick (not associated with proear in any way)
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Hi Saddler99,
Just to facilitate your understanding of this matter, allow me to first clear up some terminology:
1. As used in this thread, the words "rupture" & "perforation" can be considered synonyms.
2. I believe that by "cottorizing" Carlislere actually means "cauterizing." This is a procedure whereby tissue is sealed or closed off using heat.
As regards, "Doc~~ thank you for replying back to me. So far my ENT has told me that diving is not completely out of the question, but just for now, which i understand. Do you think, if i am allowed to continue diving, that deep dives should not occur?"
1. Yes, it would be very foolhardy to dive until the hole is closed.
2. Deep dives are not the issue, as the majority of the worrisome pressure changes and need for equilization will occur within the early atmospheres of your dives.
Best of luck.
DocVikingo
Just to facilitate your understanding of this matter, allow me to first clear up some terminology:
1. As used in this thread, the words "rupture" & "perforation" can be considered synonyms.
2. I believe that by "cottorizing" Carlislere actually means "cauterizing." This is a procedure whereby tissue is sealed or closed off using heat.
As regards, "Doc~~ thank you for replying back to me. So far my ENT has told me that diving is not completely out of the question, but just for now, which i understand. Do you think, if i am allowed to continue diving, that deep dives should not occur?"
1. Yes, it would be very foolhardy to dive until the hole is closed.
2. Deep dives are not the issue, as the majority of the worrisome pressure changes and need for equilization will occur within the early atmospheres of your dives.
Best of luck.
DocVikingo
DannyBoy
Guest
Sadler99,
The perforated eardrum repair options alluded to by yourself and DocV, namely cauterization versus tympanoplasty, are reserved for eardrum damage that does not spontaneously heal. Cauterization technique is employed (usually) for small perforations, and it involves burning the eardrum tissue to form a closure by way of scar formation. Many ENT docs, however, resort to tympanoplasty to repair perforated eardrums. This procedure usually results in a better and more pliable long-term closure for ruptured eardrums. The procedure involves taking a small piece of tissue (oftentimes from the back-side of your ear), flattening out the tissue with a press to make it paper-thin, and placing it on top of the defect in the eardrum. The middle ear is packed with absorbable material to provide support for the eardrum while it heals, and the outer ear canal is likewise packed. Stitches are usually not required in order for the graft to "take", so follow-up only requires removal of the packing from the outer ear canal before inspection and compliance testing.
This procedure can result in a more-pliable eardrum than one repaired with electrocautery. This is an important distinction for you as a diver, if only because a more compliant eardrum (i.e. one that flexes as an un-injured eardrum would) would decrease the risk of repeat injury under circumstances experienced by divers who need to frequently equalize their middle ear spaces.
What does this mean for you? If your eardrum does not heal spontaneously, I would suggest that you obtain a consultation from an ENT doctor familiar with your favorite pasttime. He may well recommend tympanoplasty as the repair of choice in your circumstance. Your eardrum will need to be evaluated after surgery for compliance before you can return to the water, but there are divers out there that I have known and/or taken care of who are able to return to diving after this surgery. I will caution you, however, that you will need to be more careful with your new eardrum and not be overly aggressive with your equalization techniques, as you will likely be at risk for repeat injury for the rest of your diving career.
HTH,
Dan
Of course, this posting is for informational purposes only and should not, in any way, be construed as implying a doctor-patient relationship.
The perforated eardrum repair options alluded to by yourself and DocV, namely cauterization versus tympanoplasty, are reserved for eardrum damage that does not spontaneously heal. Cauterization technique is employed (usually) for small perforations, and it involves burning the eardrum tissue to form a closure by way of scar formation. Many ENT docs, however, resort to tympanoplasty to repair perforated eardrums. This procedure usually results in a better and more pliable long-term closure for ruptured eardrums. The procedure involves taking a small piece of tissue (oftentimes from the back-side of your ear), flattening out the tissue with a press to make it paper-thin, and placing it on top of the defect in the eardrum. The middle ear is packed with absorbable material to provide support for the eardrum while it heals, and the outer ear canal is likewise packed. Stitches are usually not required in order for the graft to "take", so follow-up only requires removal of the packing from the outer ear canal before inspection and compliance testing.
This procedure can result in a more-pliable eardrum than one repaired with electrocautery. This is an important distinction for you as a diver, if only because a more compliant eardrum (i.e. one that flexes as an un-injured eardrum would) would decrease the risk of repeat injury under circumstances experienced by divers who need to frequently equalize their middle ear spaces.
What does this mean for you? If your eardrum does not heal spontaneously, I would suggest that you obtain a consultation from an ENT doctor familiar with your favorite pasttime. He may well recommend tympanoplasty as the repair of choice in your circumstance. Your eardrum will need to be evaluated after surgery for compliance before you can return to the water, but there are divers out there that I have known and/or taken care of who are able to return to diving after this surgery. I will caution you, however, that you will need to be more careful with your new eardrum and not be overly aggressive with your equalization techniques, as you will likely be at risk for repeat injury for the rest of your diving career.
HTH,
Dan
Of course, this posting is for informational purposes only and should not, in any way, be construed as implying a doctor-patient relationship.
You may want to check out the report by Dr. Alfred Bove titled
"Solutions for perforated ear drums" at http://www.scubamed.com/newspage.htm#anchor783180
"Solutions for perforated ear drums" at http://www.scubamed.com/newspage.htm#anchor783180
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