Possible inner ear baro-trauma recovery time?

[Dusty_Ruby]

Hello

A month ago I was recovering from a cold and had some congestion with a dive trip coming up. To check if congestion had passed I used an Otovent medical device (its basically a balloon you inflate with your nose while doing a valsalva maneuver, the point of the balloon is as visual check make sure you aren't blowing too forcefully). Basically I could not inflate the balloon at all and did an overly forceful valsalva which caused pain in both ears. Within 24 hrs I had ear fullness, intermittent tinnitus and occasional mild pain that would come and go. No vertigo or noticeable hearing loss at all. So I though it's probably not that serious. I have had mild middle ear baro trauma before that happened while diving due to rushing a descent which resolved quickly on its own. I saw my GP about this at the time. I avoided seeing a doctor this time as I didn't want a history of ear injury's on my medical record as I'm worried how this might impact future dive medicals (I need this done annually to dive in Europe)

Fast forward to now my symptoms have improved somewhat but not as fast as I though they would. I still have intermittent mild pain, intermittent tinnitus, and intermittent fullness. I do have occasions where my ears almost feel normal for a bit and then the symptoms come back. Sneezing or blowing my nose tends to make the symptoms worse - I now avoid doing this. I just had an audiology exam and my hearing was completely normal at all frequencies.

My main question is should I be concerned at the slow recovery and would it be sensible to start diving again as soon as I no longer have any symptoms.

 

[boulderjohn]

You should consult an ENT. It is possible to have a very persistent infection that will need treatment with an appropriate antibiotic.

 

[kinoons]

You need to be seen by a physician at a minimum, and possibly an ENT.

it is plausible you still have some degree of sinus and/or ear disease that is causing symptoms. This is something that a primary care physician or other healthcare provider (physician assistant on nurse practitioner in the US) could initially evaluate. I’m not sure if there is an equivalent position in Europe.

If an exam is completely reassuring with no evidence of sinus/ear infection it might still be reasonable to treat for one before chasing down a specific inner ear evaluation. More so if there is evidence of a problem.

After that getting an ENT involved would be the next step I would recommend for my patients.

 

[Dusty_Ruby]

You should consult an ENT. It is possible to have a very persistent infection that will need treatment with an appropriate antibiotic.

Thanks for your advice. I have recently had a course of Clarithromycin 500 mg for 5 days for as a toe/skin infection which apparently is also used to treat middle ear infections coincidentally. It made absolutely no difference to my ear symptoms. Of course there could be something else I am missing

 

[Duke Dive Medicine]

Hello

A month ago I was recovering from a cold and had some congestion with a dive trip coming up. To check if congestion had passed I used an Otovent medical device (its basically a balloon you inflate with your nose while doing a valsalva maneuver, the point of the balloon is as visual check make sure you aren't blowing too forcefully). Basically I could not inflate the balloon at all and did an overly forceful valsalva which caused pain in both ears. Within 24 hrs I had ear fullness, intermittent tinnitus and occasional mild pain that would come and go. No vertigo or noticeable hearing loss at all. So I though it's probably not that serious. I have had mild middle ear baro trauma before that happened while diving due to rushing a descent which resolved quickly on its own. I saw my GP about this at the time. I avoided seeing a doctor this time as I didn't want a history of ear injury's on my medical record as I'm worried how this might impact future dive medicals (I need this done annually to dive in Europe)

Fast forward to now my symptoms have improved somewhat but not as fast as I though they would. I still have intermittent mild pain, intermittent tinnitus, and intermittent fullness. I do have occasions where my ears almost feel normal for a bit and then the symptoms come back. Sneezing or blowing my nose tends to make the symptoms worse - I now avoid doing this. I just had an audiology exam and my hearing was completely normal at all frequencies.

My main question is should I be concerned at the slow recovery and would it be sensible to start diving again as soon as I no longer have any symptoms.

I would strongly recommend that you not dive until your symptoms have completely resolved. Based on the information you've provided it sounds like there's reason for optimism that you'll make a full recovery, but if there's still inflammation in there you're risking re-injuring your ears and possibly making things worse.

It's unfortunate that the fear of being denied clearance to dive is your reason for not seeking help. A couple of thoughts on that, for what they're worth: first, I understand the reasoning, but inner ear symptoms are nothing to trifle with. If you think you need medical attention, get it, and worry about the diving later. Here's a link to the UKDMC website with a list of medical referees. Second, this speaks to a debate in a previous thread on mandatory periodic diving medical exams.

Best regards,
DDM

 

[cfberry]

get an ENT opinion