perilymph fistula

[doctormike]

Thanks for sharing your thoughts.

Do you think I should request some kind of imaging to be done?

oh and by the way I am a women not a man.....

Far more important that requesting a specific test is that you find a physician with experience in this field who has had the chance to examine you.

Is the doctor that yo are working with an ENT doctor who specializes in ear problems (an otologist)..? If not, and if you tell me where you are writing from (here or by PM if you prefer), I may be able to give you a local referral.

Good luck!

Mike

 

[Duke Dive Medicine]

When diving I have no problems clearing my ears and my dives are just fine, but a day or so after a dive my ear becomes completely plugged up, hearing loss, ringing in my head and just total discomfort. I went to EN&T doctor and he has advised I have perilymph fistula

Agent 52, how long do your symptoms last after you dive? Has this happened multiple times, and if so, does it follow the same course? Are you using the valsalva (pinch your nose and blow) maneuver to clear your ears, and if so, how hard do you do it?

 

[Agent 52]

Yes I am seeing a EN&T Specialist in the Everett WA area. Any referral will be appreciated.
Symptons last 7 to 10 days after a dive, yes this has happened the last 5 dives or so. Yes I use the valsalva maneuver and have no problems clearing my ears, I think I am doing it softly but if and when I get back into the water I know I will be doing some experimenting on how softly I can do it....

 

[doctormike]

Hi,

If you are happy with your ENT doc, that is fine... if you want a local referral in otology, here is the list from our academy Web site within 100 miles of your zip code. I don't know any of these docs personally...


James V Crawford, MD Tacoma, WA 98431-0001
Mark B. Emery, MD Auburn, WA 98002
Richard Hoistad, MD Seattle, WA 98104
May Y Huang, MD Seattle, WA 98104-3555
Clifford R Hume, MD PhD Seattle, WA 98195
Alan W Langman, MD Seattle, WA 98115-2047
Constantine William Palaskas, MD Seattle, WA 98104-2138
Constantine William Palaskas, MD Bellevue, WA 98004
Jay T Rubinstein MD PhD Seattle, WA 98195-7923
Seth R. Schwartz, MD MPH Seattle, WA 98111
Herbert C. Thomas, Jr, MD Seattle, WA 98105-3901
Matthew L Wong, II, MD Seattle, WA 98104-330

Best,

Mike

 

[Duke Dive Medicine]

Yes I am seeing a EN&T Specialist in the Everett WA area. Any referral will be appreciated.
Symptons last 7 to 10 days after a dive, yes this has happened the last 5 dives or so. Yes I use the valsalva maneuver and have no problems clearing my ears, I think I am doing it softly but if and when I get back into the water I know I will be doing some experimenting on how softly I can do it....

It's impossible to make a solid diagnosis via the internet, but if you are recovering fully after 7-10 days without any residual problems, then perilymph fistula is not the first thing that comes to mind here. PF is normally caused by a forceful valsalva that increases the pressure in your inner ear enough to pop either the round or oval window. "Doing it softly" is relative, but if you're not squeezing your eyelids shut and chomping your mouthpiece while you do it (only half joking), then you're probably ok. Seeing the ENT is a good idea. Make sure you are prepared to give him/her a thorough history including allergies, chronic sinusitis, and anything else that might be pertinent. Best of luck!
Kindest regards,
Duke Dive Medicine

 

[gkwalt]

I hope folks are still following this thread. About 20 years ago while ascending from a 70' dive, I experienced sudden onset of vertigo and tinnitus at about 10 feet. The dive was completely uneventful. We were recovering a body in a car and I made maybe 4 or 5 quick descends to the bottom. The vertigo passed quickly, but the ringing persisted. I saw the department doc (I was a police diver at the time) who said take antihistamines and ask me why we didn't wear earplugs to protect our ears?! I followed with an ENT and still had ringing and a hearing loss. He diagnosed a PLF and I had surgery where he took some fat from my earlobe the plug the presumed hole in my round window. I stopped diving on his recommendation for about 15 years. After some reading I decided to roll the dice and dive again. Now I have no problems clearing, no vertigo, slight ringing and a stable hearing deficit. After all my reading and after reading this thread, I'm not sure what I had. But I am glad to be back diving again.

 

[Agent 52]

Thanks for everyone's responses. I am not willing to stop diving for 15 years it has been hard enough to stay out of the water since end of September. After imaging being done where all appeared fine, steriod treatment that improved hearing loss and some pressure tests my ENT is going to let me get back in the water around Dec 2nd and we will go from there.....can't wait! Happy Safe Diving to all

 

[Agent 52]

Hello

Wanted to share what has been going on since my last post. I stayed out of the water for 3 months during that time period I had no ear issues except for after my
Audiologist gave me a pressure test, all was well until 8 days later, then back to not being able to hear and fullness and ringing in my head, back on steroids treatment. Steriods cleared it up once again. Dr. is advising CT scan looks good, all blood tests taken are fine..he doesn't know what to do and told me I could go diving again. I went diving Dec 26 (awesone after being out for 3 months) no troubles good dive. Now 10 days later I wake up to no hearing in my right ear, fullness and ringing going on. I really do not know what to do. I have a dive planned for Sunday but not sure if I should be going or not. Could this possibly be something other than related to diving?

 

[doctormike]

Hello

Wanted to share what has been going on since my last post. I stayed out of the water for 3 months during that time period I had no ear issues except for after my
Audiologist gave me a pressure test, all was well until 8 days later, then back to not being able to hear and fullness and ringing in my head, back on steroids treatment. Steriods cleared it up once again. Dr. is advising CT scan looks good, all blood tests taken are fine..he doesn't know what to do and told me I could go diving again. I went diving Dec 26 (awesone after being out for 3 months) no troubles good dive. Now 10 days later I wake up to no hearing in my right ear, fullness and ringing going on. I really do not know what to do. I have a dive planned for Sunday but not sure if I should be going or not. Could this possibly be something other than related to diving?

It would be hard to reassure you that that this is not in someway related to diving and/or a PLF if you ended up with a sensorineural loss on two more occasions.. Again, we can't diagnose over the Internet, but the only way of diagnosing a PLF is surgical exploration (even then it is controversial). It is strange that it didn't happen for 10 days, though... Any dizziness? Did the doctor suggest Meniere's disease...?

Did you ever get in touch with one of those otologists in your area? I would hold off on diving until you get a diagnosis - CT and blood tests would rarely be helpful in this sort of situation...