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Hi there,
I would be very grateful if forum members, especially those with a medical background, could give me their opinion on my situation summarised below. I am due to see ENT shortly and would like to be as informed as possible before my appointment. Many thanks in advance!
To summarise, about a month ago (32 days to be precise) I had an accident diving in the Galápagos. On the first dive I had some difficulty equalising (as I often do) but eventually made it down and completed the dive, although in truth I never felt 100% comfortable. On ascent my right ear made a continuous loud squeaky sound, though at no point during either my descent or ascent did I feel any pain. On the surface I noticed I couldn’t hear well with that ear as well as a loud ringing sound, but given in the past I have been prone to mild middle-ear barotraumas as well as getting water stuck in my ear, I didn’t worry too much about it and chose to proceed with the second dive, almost certainly a huge mistake. I also remember feeling quite nauseous but put that down to seasickness, though in retrospect I believe it had something to do with the damage I had just done to my ear. In any case I didn’t have any pain or problems equalising on the second dive.
Back on land the hearing problems and ringing continued, along with a feeling of vertigo/loss of balance which I hadn’t experienced with previous barotraumas. This made me concerned enough to visit a doctor the next day, who while not an ENT was used to dealing with the many divers who visit the Galápagos. He had a quick look at my ear, said it was filled with blood and diagnosed me with a middle ear barotrauma, dismissing my concerns about an inner ear injury by saying that my vertigo would be far worse and I would be vomiting if that were the case. He prescribed me a course of antibiotics, a decongestant and ibuprofen which I took for a week.
While the vertigo/balance issues and ringing went away in a couple of days, my muffled hearing did not improve. However given my aforementioned history with middle-ear barotraumas that eventually resolved themselves, as well advice I read online that barotraumas can take weeks if not months to fully heal, I decided not to worry about it and enjoy my holiday. That was until I began to notice that unlike my previous barotraumas, it wasn’t only muffled hearing that I was suffering from but also a distortion of high-pitched sounds (for example from plastic bags or running water) and difficulty following conversation with the injured ear.
At this point I began feeling seriously worried that I had permanently damaged my hearing, and so after flying back to mainland Ecuador from the islands I went to see an ENT specialist in the capital (Quito) 17 days after the accident (I am traveling for several months across Latin America which is why I am unable to see a specialist back home in the UK). Although he could see no physical problems in my affected ear (after examining it visually and with a device that measures pressure) the audiogram he ran showed high-frequency hearing loss beginning above above 4Khz and worsening steadily beyond that point (hitting 40db at 6k Hz and 70db at 8k Hz). Although he couldn’t identify the cause of the hearing loss, he told me it was likely permanent and caused by the barotrauma. He put me on a course of steroids (Prednisone 60mg daily for a week) despite acknowledging it was probably too late for them to help, and told me to visit another ENT doctor in about 2 weeks time to see if my hearing had improved. Unfortunately I don’t believe the steroids have made a difference to my hearing.
Which brings us to the present. In advance of my appointment on Friday, could you give me your opinion on what you think happened to my ear on my dives and whether there are any emergency measures that could still be taken at this relatively late stage to improve my hearing? The only thing that comes to mind is surgery to repair a perilymph fistula I might have suffered during the dive, but based on my reading it appears to be quite a controversial diagnosis and procedure which I’d have a hard time convincing an ENT to undertake. It also appears far less likely to be helpful if not carried out in the immediate aftermath of the accident. However if it has a chance of saving my hearing then I will push to get it done. Something that also perplexes me is that while I was diagnosed with hearing loss only in the high frequencies, all sounds (not just high-frequency ones) sound slightly muffled through the affected ear, making me wonder if I have some remaining conductive hearing loss caused by fluid that the ENT I saw in Quito was unable to see - is that a possibility?
Any thoughts on the above would be hugely appreciated,
Many thanks,
Max
I would be very grateful if forum members, especially those with a medical background, could give me their opinion on my situation summarised below. I am due to see ENT shortly and would like to be as informed as possible before my appointment. Many thanks in advance!
To summarise, about a month ago (32 days to be precise) I had an accident diving in the Galápagos. On the first dive I had some difficulty equalising (as I often do) but eventually made it down and completed the dive, although in truth I never felt 100% comfortable. On ascent my right ear made a continuous loud squeaky sound, though at no point during either my descent or ascent did I feel any pain. On the surface I noticed I couldn’t hear well with that ear as well as a loud ringing sound, but given in the past I have been prone to mild middle-ear barotraumas as well as getting water stuck in my ear, I didn’t worry too much about it and chose to proceed with the second dive, almost certainly a huge mistake. I also remember feeling quite nauseous but put that down to seasickness, though in retrospect I believe it had something to do with the damage I had just done to my ear. In any case I didn’t have any pain or problems equalising on the second dive.
Back on land the hearing problems and ringing continued, along with a feeling of vertigo/loss of balance which I hadn’t experienced with previous barotraumas. This made me concerned enough to visit a doctor the next day, who while not an ENT was used to dealing with the many divers who visit the Galápagos. He had a quick look at my ear, said it was filled with blood and diagnosed me with a middle ear barotrauma, dismissing my concerns about an inner ear injury by saying that my vertigo would be far worse and I would be vomiting if that were the case. He prescribed me a course of antibiotics, a decongestant and ibuprofen which I took for a week.
While the vertigo/balance issues and ringing went away in a couple of days, my muffled hearing did not improve. However given my aforementioned history with middle-ear barotraumas that eventually resolved themselves, as well advice I read online that barotraumas can take weeks if not months to fully heal, I decided not to worry about it and enjoy my holiday. That was until I began to notice that unlike my previous barotraumas, it wasn’t only muffled hearing that I was suffering from but also a distortion of high-pitched sounds (for example from plastic bags or running water) and difficulty following conversation with the injured ear.
At this point I began feeling seriously worried that I had permanently damaged my hearing, and so after flying back to mainland Ecuador from the islands I went to see an ENT specialist in the capital (Quito) 17 days after the accident (I am traveling for several months across Latin America which is why I am unable to see a specialist back home in the UK). Although he could see no physical problems in my affected ear (after examining it visually and with a device that measures pressure) the audiogram he ran showed high-frequency hearing loss beginning above above 4Khz and worsening steadily beyond that point (hitting 40db at 6k Hz and 70db at 8k Hz). Although he couldn’t identify the cause of the hearing loss, he told me it was likely permanent and caused by the barotrauma. He put me on a course of steroids (Prednisone 60mg daily for a week) despite acknowledging it was probably too late for them to help, and told me to visit another ENT doctor in about 2 weeks time to see if my hearing had improved. Unfortunately I don’t believe the steroids have made a difference to my hearing.
Which brings us to the present. In advance of my appointment on Friday, could you give me your opinion on what you think happened to my ear on my dives and whether there are any emergency measures that could still be taken at this relatively late stage to improve my hearing? The only thing that comes to mind is surgery to repair a perilymph fistula I might have suffered during the dive, but based on my reading it appears to be quite a controversial diagnosis and procedure which I’d have a hard time convincing an ENT to undertake. It also appears far less likely to be helpful if not carried out in the immediate aftermath of the accident. However if it has a chance of saving my hearing then I will push to get it done. Something that also perplexes me is that while I was diagnosed with hearing loss only in the high frequencies, all sounds (not just high-frequency ones) sound slightly muffled through the affected ear, making me wonder if I have some remaining conductive hearing loss caused by fluid that the ENT I saw in Quito was unable to see - is that a possibility?
Any thoughts on the above would be hugely appreciated,
Many thanks,
Max
