Recovery time for suspected barotrauma & considering septoplasty

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fluff_astrid

Contributor
Messages
72
Reaction score
43
Location
Sydney, Australia
# of dives
100 - 199
I'd like thoughts on whether my situation might self-resolve (and within what timeframe), or if I should try a septoplasty / balloon dilation to help set my ear up for success.

Background: Whether a cause or not, I have a bad deviated septum on the left side. And normally my left ear gives me a bit of equalization trouble. But typically I can manage it. I'm always doing equalization on land and have been diving locally (shore and boat) in my area without any notable incidents.

In early September, I went to Hawaii, dove 24 hours after my flight, and experienced a suspected barotrauma. I had no noticeable congestion, experienced no equalization issues on the incoming flight, and I had been shore diving just a week prior. I had equalized fine on the boat. But on this descent, I think I must have gone a little too quickly before I tried equalizing. I experienced a little pain (nothing serious), ascended, and then struggled for 10 minutes close to the surface to equalize. Eventually I got my ear to a point where it didn't hurt and squeaked to equalize. Thinking that was enough, I descended (with squeaky equalization) and continued the dive around 16-18m depth. I thought that was the end of my troubles, but then I noticed that if I shifted just a few feet my ear would hurt and need to be re-equalized and was much more sensitive to pressure changes that I was used to. Upon returning to the boat, I had muffled hearing. Uh oh.

The muffled hearing went away thankfully a few days after, no pain or anything, and felt like I could clear it (although it was a bit duller than normal). Out of curiosity, I tried diving again 3 days later (on a line in a highly controlled environment with the assumption I wouldn't get far) and got down to 8m, but then we had to go back up because another diver was underweighted, and upon trying to descend a second time, it was a hard no-go. I aborted the dive. I had muffled hearing again after that dive, which went away within a few hours but left my ear feeling slightly stuffy and with what I would call a "dull" clearing sensation compared to my right ear. I haven't tried diving since.

I saw an urgent care doctor in Hawaii who did not see any evidence of fluid or bruising, and definitely no inner ear issues, but simply noted my left eardrum was retracted and gave me Flonase. Two weeks later I flew back from Hawaii and during descent, my left ear seriously struggled, but I made it.

After getting back I hoped it would self-resolve within a month, but while there's no more feeling of fullness or muffled hearing, clearing still feels unsatisfying (I did have a brief bout with Covid about 4 weeks ago, shortly after my trip, which probably set it back a week but cleared up fairly quickly). I made an appointment with an ENT who I just saw this past week.

The ENT took a look at my eardrum and said that it is now slightly bulging, and didn't fully deflate when I she asked me to equalize. It was a bit inflexible. It's unclear if this rigidity was because of the barotrauma or the cause of it. Then, we discussed my deviated septum--I've had a bad deviation on the left side for years and in the past have talked with this ENT about surgery, but we've opted for conservative approaches. However, at this appointment during the nasal endoscopy it was clear that the nasal passageways have gotten tighter, and didn't just look tight on my left side but now also my right side (and associated congestion up there because of it). So we had a conversation about septoplasty again as well as a potential balloon dilation.

Anyways...
If we assume I indeed had a middle ear barotrauma on my trip, just not enough to produce fluid or obvious erythmia, is it worth expecting that my ear will eventually self-resolve? How long can that take (when I chatted with DAN, they said a month, but it's been more than that)? Or is it possible/likely I have a bigger issue that made it more susceptible to barotrauma, that I should focus on resolving? And, are septoplasty and balloon dilation procedures that can improve equalization ability?
 
I'd like thoughts on whether my situation might self-resolve (and within what timeframe), or if I should try a septoplasty / balloon dilation to help set my ear up for success.

Background: Whether a cause or not, I have a bad deviated septum on the left side. And normally my left ear gives me a bit of equalization trouble. But typically I can manage it. I'm always doing equalization on land and have been diving locally (shore and boat) in my area without any notable incidents.

In early September, I went to Hawaii, dove 24 hours after my flight, and experienced a suspected barotrauma. I had no noticeable congestion, experienced no equalization issues on the incoming flight, and I had been shore diving just a week prior. I had equalized fine on the boat. But on this descent, I think I must have gone a little too quickly before I tried equalizing. I experienced a little pain (nothing serious), ascended, and then struggled for 10 minutes close to the surface to equalize. Eventually I got my ear to a point where it didn't hurt and squeaked to equalize. Thinking that was enough, I descended (with squeaky equalization) and continued the dive around 16-18m depth. I thought that was the end of my troubles, but then I noticed that if I shifted just a few feet my ear would hurt and need to be re-equalized and was much more sensitive to pressure changes that I was used to. Upon returning to the boat, I had muffled hearing. Uh oh.

The muffled hearing went away thankfully a few days after, no pain or anything, and felt like I could clear it (although it was a bit duller than normal). Out of curiosity, I tried diving again 3 days later (on a line in a highly controlled environment with the assumption I wouldn't get far) and got down to 8m, but then we had to go back up because another diver was underweighted, and upon trying to descend a second time, it was a hard no-go. I aborted the dive. I had muffled hearing again after that dive, which went away within a few hours but left my ear feeling slightly stuffy and with what I would call a "dull" clearing sensation compared to my right ear. I haven't tried diving since.

I saw an urgent care doctor in Hawaii who did not see any evidence of fluid or bruising, and definitely no inner ear issues, but simply noted my left eardrum was retracted and gave me Flonase. Two weeks later I flew back from Hawaii and during descent, my left ear seriously struggled, but I made it.

After getting back I hoped it would self-resolve within a month, but while there's no more feeling of fullness or muffled hearing, clearing still feels unsatisfying (I did have a brief bout with Covid about 4 weeks ago, shortly after my trip, which probably set it back a week but cleared up fairly quickly). I made an appointment with an ENT who I just saw this past week.

The ENT took a look at my eardrum and said that it is now slightly bulging, and didn't fully deflate when I she asked me to equalize. It was a bit inflexible. It's unclear if this rigidity was because of the barotrauma or the cause of it. Then, we discussed my deviated septum--I've had a bad deviation on the left side for years and in the past have talked with this ENT about surgery, but we've opted for conservative approaches. However, at this appointment during the nasal endoscopy it was clear that the nasal passageways have gotten tighter, and didn't just look tight on my left side but now also my right side (and associated congestion up there because of it). So we had a conversation about septoplasty again as well as a potential balloon dilation.

Anyways...
If we assume I indeed had a middle ear barotrauma on my trip, just not enough to produce fluid or obvious erythmia, is it worth expecting that my ear will eventually self-resolve? How long can that take (when I chatted with DAN, they said a month, but it's been more than that)? Or is it possible/likely I have a bigger issue that made it more susceptible to barotrauma, that I should focus on resolving? And, are septoplasty and balloon dilation procedures that can improve equalization ability?
Hi @fluff_astrid ,

The inflammation from barotrauma can take several weeks to resolve. I would recommend not diving for at least that long and seeing if this resolves without intervention first. If you're 12 weeks out and still having symptoms and/or you can't equalize, it might be reasonable to explore options with your ENT consultant.

Best regards,
DDM
 
Consult Diver Alert Network
 
Anyways...
If we assume I indeed had a middle ear barotrauma on my trip, just not enough to produce fluid or obvious erythmia, is it worth expecting that my ear will eventually self-resolve? How long can that take (when I chatted with DAN, they said a month, but it's been more than that)? Or is it possible/likely I have a bigger issue that made it more susceptible to barotrauma, that I should focus on resolving? And, are septoplasty and balloon dilation procedures that can improve equalization ability?
Hi,

Being in a similar condition, I'd love to know how long it did take for your trouble to clear up.
 
https://www.shearwater.com/products/swift/

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