Pinhole in Eardrum...

[CrackedConch]

I dove from 12/28/07-1/6/08 in the Florida Keys and Springs. At about 70' on French Reef, I heard a small "snap" and then heard a squealing air-escaping sound. I thought it was just a normal sinus equalization squeal.

The subsequent ear infection sent me to the ENT and it turns out I have a pinhole in my right eardrum. The squeal was air escaping and water trickling into my middle ear. In the evaluation, the ENT also said my eardrum looks slightly caved in/concave.

I've been for hearing tests (mostly normal with minor hearing loss at low and high frequencies, but not way out of range), CT scan to check the alignment and deterioration of the bones in my ear (normal), and a tympanogram (flatlined in the right ear, normal in the left), but I still have the pinhole (hence the flat tympanogram).

My ENT now wants to refer me to an Otologist for further evaluation and discussion of possible surgery to fix the pinhole and maybe address the concave shape at the same time.

I hoped some of the medical moderators/professionals on here could share some of their experience on this. Obviously, I'm most concerned about getting healed but also about the likelihood and timeline of returning to diving.

I fully recognize that everybody's medical situation is different and I'm not asking anybody for official medical advice. I just hope to get some insight from fellow divers who may have seen similar situations.

I also plan to call DAN...

Thanks in advance!

 

[jbd]

You might get a better response if you post this or ask a moderator to move it to the medical section. Having said that, way back in my younger days it was quite common for ENT's to insert tubes in kids ears to deal with recurrent ear infections. These tubes would eventually come out and the tympanic membrane would heal on its own in most all cases that I am aware of. The hole made in the tympanic membrane for the tuube was much bigger than what I would call a pinhole. I would think the pinhole will heal on its own. You should monitor it via qualified medical exam. If it doesn't heal over time you may need the surgery but I wouldn't rush to have surgery---all surgical procedures have their inherent risks.

BTW as I recall, although it has been many years, the tympanic membrane is normally concave when viewed through an otoscope. Kind of a shallow cone shape.

 

[DocVikingo]

Hi CrackedConch,

Given time, pinhole perforations of the eardrum usually resolve spontaneously if not further provoked. That the ENT has suggested referral to a specialist expert in the surgical management of such perforations suggests that routine healing is for some reason not anticipated. In any event, having an otologist examine the ear should do no harm.

The repair of such conditions, called tympanoplasty, typically involves taking a tiny piece of tissue from a muscle behind the ear and affixing it under the hole in the ear drum. In general, the procedure is relatively brief, done on an outpatient basis and has a high rate of success.

It will take several weeks to determine if the tympanoplasty was a success. In uncomplicated cases, complete recovery takes about four weeks.

The timing of return to SUBA is, of course, is a decision to be made by the patient and his doctor.

Helpful?

DocVikingo

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.

 

[CrackedConch]

Very helpful and it provides me hope--thank you!

My doctors have been great, but they are not divers. Their explanations have stopped at the point of describing the tympanoplasty.

So naturally I was curious about the outlook on returning to diving post-surgery. Thanks again!!