Question Persistent Ear Issues for 5 Months

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noboruwatanabe

Registered
Messages
6
Reaction score
2
Location
Québec, Canada
# of dives
50 - 99
Hi folks, thanks for letting me post this. If anyone has the time to read and respond, I will be extremely grateful.

Background:

I completed 80 dives in the past 1.5 years before the incident, I had never been diving before. When equalizing, my right ear has always "crackled" and "popped". I had difficulty equalizing on 6 dives, despite not feeling congested - initially I tried to force a valsalva, however I stopped after the first couple instances when I learned of the consequences. After my first ever dives, my ear would feel full and ring, which would disappear after a few days.

After about 15 dives, I developed persistent mild tinnitus and the feeling of pressure in my ear, resulting in the need to equalize thoroughout the day. I visited an audiologist (hearing is fine) and an ENT. The ENT sent me for some scans, which confirmed I have a deviated septum, which could explain the equalization challenges. The ENT had no concerns of me continuing to dive. Shortly after, I moved to Canada and didn't dive for 4 months. I believe my tinnitus and ear pressure improved - it was still present, but either improved or I just got used to it.

One other point to note, I am not sure of its importance - on 2 of these 80 dives, I experienced the feeling of cold water entering my ear/head that made me shiver quite extremely and felt sharp pain for a second after equalizing. Both times, it was a routine valsalva equalization at depth that was not forced. I asked my dive instructor and ENT about this and they didn't really have any comment or answer.

The issue/incident:

4 months later, I am in Canada and start diving again. On the first dive, I experience no issues equalizing on descent. However, at depth (around 20m/65ft), I experience the cold water entering my ear/shiver/sharp pain once again. After this dive, my tinnitus is a bit more noticeable and pressure in my ear feels greater throughout the day. Since my ENT had no concerns, I continue to dive around 4 more times.

In mid-September, I do a freediving course. I have trouble equalizing during rapid descent, however I am careful not to force the valsalva manouever. When I am unable to equalize, I surface and try again until I am able to. A couple of times it is more painful/uncomfortable than I intend. After this 3-day course, the tinnitus is much louder in my right ear but I have no other symptoms. I am concerned so do not dive again to monitor the symptoms. After a few weeks, I develop hyperacusis and experience discomfort when unloading the dishwasher, etc. The tinnitus remains consistent - loud, high-pitched, very annoying.

6 weeks later, I purchased ear buds. I use them, then the next day my tinnitus seems even louder - I realize I have potentially made things worse and never use them or any other headphones again. I panic and visit the doctor (with much difficulty in Canada). He says it's probably some kind of barotrauma and asks if "I want to be prescribed" antibiotics and/or a nasal steroid spray. I ask if he thinks they are required. He doesn't know, but they might help. Exasperated, I take the prescription for both but neither seem to help. The doctor referred me to an ENT, but the earliest appt I could book is mid-June(!).

I also went to an audiologist around this time, who confirmed my hearing was fine.

This was 3 months ago. Since then, the hyperacusis disappeared (for a while) but tinnitus and pressure feeling remained. I have stayed out of the water, but taken 5 flights around christmas time to see family, with no apparrent issues.

Around 2 weeks ago, I started having problems where my ear felt clogged with ear wax (it would get "stuck"/blocked). I went to an audiologist who cleaned my ears by squirting water in them (i think this was a bad move given my current condition, it all happened very quickly). She noticed that my eardrum was "very red and bubbly".

Since last week, I've started to feel hyperacusis again and am experiencing occasional pain/discomfort in my ear.

I am concerned the symptoms have not improved in 5 months since the incident, and seem to be getting worse. However, my symptoms still seem less significant than some of the Middle Ear Barotrauma or IEBT symptoms (no hearing loss, vertigo, dizziness). I have no idea if this is IEBT or MEBT, as I have some symptoms of both.

Given I need to wait until June to see an ENT in Canada, I am considering if it is worth the expense of seeking an appointment with an ENT specialist in the US. I can't really afford this, but if it will help prevent further/permanent damage, it may be worth it.

Does anyone here have any similar experience that could help in understanding if this is MEBT or IEBT, and if it would be worth going to see a specialist ASAP or wait until June?

I greatly appreciate the time anyone has taken to read this.
 
Hi folks, thanks for letting me post this. If anyone has the time to read and respond, I will be extremely grateful.

Background:

I completed 80 dives in the past 1.5 years before the incident, I had never been diving before. When equalizing, my right ear has always "crackled" and "popped". I had difficulty equalizing on 6 dives, despite not feeling congested - initially I tried to force a valsalva, however I stopped after the first couple instances when I learned of the consequences. After my first ever dives, my ear would feel full and ring, which would disappear after a few days.

After about 15 dives, I developed persistent mild tinnitus and the feeling of pressure in my ear, resulting in the need to equalize thoroughout the day. I visited an audiologist (hearing is fine) and an ENT. The ENT sent me for some scans, which confirmed I have a deviated septum, which could explain the equalization challenges. The ENT had no concerns of me continuing to dive. Shortly after, I moved to Canada and didn't dive for 4 months. I believe my tinnitus and ear pressure improved - it was still present, but either improved or I just got used to it.

One other point to note, I am not sure of its importance - on 2 of these 80 dives, I experienced the feeling of cold water entering my ear/head that made me shiver quite extremely and felt sharp pain for a second after equalizing. Both times, it was a routine valsalva equalization at depth that was not forced. I asked my dive instructor and ENT about this and they didn't really have any comment or answer.

The issue/incident:

4 months later, I am in Canada and start diving again. On the first dive, I experience no issues equalizing on descent. However, at depth (around 20m/65ft), I experience the cold water entering my ear/shiver/sharp pain once again. After this dive, my tinnitus is a bit more noticeable and pressure in my ear feels greater throughout the day. Since my ENT had no concerns, I continue to dive around 4 more times.

In mid-September, I do a freediving course. I have trouble equalizing during rapid descent, however I am careful not to force the valsalva manouever. When I am unable to equalize, I surface and try again until I am able to. A couple of times it is more painful/uncomfortable than I intend. After this 3-day course, the tinnitus is much louder in my right ear but I have no other symptoms. I am concerned so do not dive again to monitor the symptoms. After a few weeks, I develop hyperacusis and experience discomfort when unloading the dishwasher, etc. The tinnitus remains consistent - loud, high-pitched, very annoying.

6 weeks later, I purchased ear buds. I use them, then the next day my tinnitus seems even louder - I realize I have potentially made things worse and never use them or any other headphones again. I panic and visit the doctor (with much difficulty in Canada). He says it's probably some kind of barotrauma and asks if "I want to be prescribed" antibiotics and/or a nasal steroid spray. I ask if he thinks they are required. He doesn't know, but they might help. Exasperated, I take the prescription for both but neither seem to help. The doctor referred me to an ENT, but the earliest appt I could book is mid-June(!).

I also went to an audiologist around this time, who confirmed my hearing was fine.

This was 3 months ago. Since then, the hyperacusis disappeared (for a while) but tinnitus and pressure feeling remained. I have stayed out of the water, but taken 5 flights around christmas time to see family, with no apparrent issues.

Around 2 weeks ago, I started having problems where my ear felt clogged with ear wax (it would get "stuck"/blocked). I went to an audiologist who cleaned my ears by squirting water in them (i think this was a bad move given my current condition, it all happened very quickly). She noticed that my eardrum was "very red and bubbly".

Since last week, I've started to feel hyperacusis again and am experiencing occasional pain/discomfort in my ear.

I am concerned the symptoms have not improved in 5 months since the incident, and seem to be getting worse. However, my symptoms still seem less significant than some of the Middle Ear Barotrauma or IEBT symptoms (no hearing loss, vertigo, dizziness). I have no idea if this is IEBT or MEBT, as I have some symptoms of both.

Given I need to wait until June to see an ENT in Canada, I am considering if it is worth the expense of seeking an appointment with an ENT specialist in the US. I can't really afford this, but if it will help prevent further/permanent damage, it may be worth it.

Does anyone here have any similar experience that could help in understanding if this is MEBT or IEBT, and if it would be worth going to see a specialist ASAP or wait until June?

I greatly appreciate the time anyone has taken to read this.
Hello @noboruwatanabe ,

From your detailed description, it sounds like you may have some underlying Eustachian tube dysfunction in the right ear that led to your initial injury, and then you kept re-traumatizing it. As @doctormike , our resident ENT here, would say, a deviated septum would not affect your ability to equalize your ears since the opening (meatus) of the Eustachian tube is further down in the back of your throat. Middle ear inflammation can be stubbornly slow to resolve.

The ongoing tinnitus and hyperacuisis are concerning, as is the audiologist's assessment of your TM being red and bubbly this far out from the mechanism of injury. Are you continuing to try to equalize the ear with a Valsalva maneuver? If so, I would recommend you stop immediately. It is possible that you have a combination of middle ear barotrauma and inner ear barotrauma, and attempting to equalize the ear could aggravate it. Also, I would strongly recommend that you not dive until you get resolution on this.

Where in Canada are you?

Best regards,
DDM
 
Hello @noboruwatanabe ,

From your detailed description, it sounds like you may have some underlying Eustachian tube dysfunction in the right ear that led to your initial injury, and then you kept re-traumatizing it. As @doctormike , our resident ENT here, would say, a deviated septum would not affect your ability to equalize your ears since the opening (meatus) of the Eustachian tube is further down in the back of your throat. Middle ear inflammation can be stubbornly slow to resolve.

The ongoing tinnitus and hyperacuisis are concerning, as is the audiologist's assessment of your TM being red and bubbly this far out from the mechanism of injury. Are you continuing to try to equalize the ear with a Valsalva maneuver? If so, I would recommend you stop immediately. It is possible that you have a combination of middle ear barotrauma and inner ear barotrauma, and attempting to equalize the ear could aggravate it. Also, I would strongly recommend that you not dive until you get resolution on this.

Where in Canada are you?

Best regards,
DDM
Thank you for taking the time to respond, @Duke Dive Medicine .

I have not been diving since freediving in September, I will keep it this way until resolution.

I feel the need to equalize constantly throughout the day, which I usually do by moving my jaw but occasionally valsalva - I'll make a conscious effort to not do this.

I am in the Montreal area.

Many thanks,
NW
 
Thank you for taking the time to respond, @Duke Dive Medicine .

I have not been diving since freediving in September, I will keep it this way until resolution.

I feel the need to equalize constantly throughout the day, which I usually do by moving my jaw but occasionally valsalva - I'll make a conscious effort to not do this.

I am in the Montreal area.

Many thanks,
NW
If you're in Montreal, you might consider contacting the hyperbaric unit at The Ottawa Hospital. They may have a go-to ENT physician who knows divers. Sending contact info via DM.

Best regards,
DDM
 

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