Returning to Diving

[Taxus812]

I have not dove in about 14 years. Since then I have gained a lot of weight. I am making a determined effort to loose 50+ lbs and would like to use diving as a reward and something to focus my workout towards. (EX: meet goal get a refresher class get a new mask for another etc)

One blocker that I can see, but need some advice is. I had sinus Surgery to remove two cysts (90% blockage on my right and 80% blockage on my left sinus), they also widened the upper sinus opening with a balloon. I had a complication during the surgery where the bone between my sinus and my brain crumbled leaking cerebral spinal fluid into the sinus. They patched the damage and grafters mucosal tissue over the patch.

Before I speak with my ENT I wanted to see if my diving days are done and perhaps I should look at other goals.

Thanks for the help

 

[TSandM]

I think only the person who knows exactly what was done in this surgery can answer your question. Basically, the question is whether the cribriform plate is solid enough to be able to tolerate some pressure changes, and we simply can't answer that. If it is, there should be no problems with diving.

 

[Taxus812]

Well this is a step in the right direction. I was more wondering if this was an impossibility simply because of the wound. I have an apt with my ENT next month to check on the healing. I will broach the subject with him then.

What key things should I be asking him.

1) Can the repair take pressure ?

 

[doctormike]

Well this is a step in the right direction. I was more wondering if this was an impossibility simply because of the wound. I have an apt with my ENT next month to check on the healing. I will broach the subject with him then.

What key things should I be asking him.

1) Can the repair take pressure ?

I think that you need to understand the reality of this situation before even considering diving again.

CSF leaks after sinus surgery are usually patched with soft tissue (like a fat graft), cartilage or implanted material (like Alloderm), generally from "below" (through the nose). This, combined with a period of lowering the CSF pressure using medication or spinal drains eventually gets the low pressure leak to seal off. Major repairs are usually done in cases of major trauma (like assaults or motor vehicle accidents with skull base fractures).

But no matter what the doctor did, the bottom line is that there will never be a scientific study to answer this question, since no one is going to take patients who have had this surgery and determine the ambient pressure threshold for rupture of the repair. Anything else is just a guess.

In contrast, with tympanic membrane perforations, the "repair" is considered to be as strong as the native eardrum, because you are not really using a patch in the common sense of the word. The tympanic membrane graft just acts as a scaffold to help the eardrum heal itself. But this is different, especially if a significant amount of bone was lost.

Just like people who want to dive after repair of a perilymph fistula (inner ear leak), or during pregnancy, you can convince yourself that some expert physician can "clear" you for diving, but there is no science behind such an opinion. You need to understand that even if this doctor had a patient before who had this repair and then went diving successfully, that doesn't mean that you won't have a problem. And this is a potentially big problem.

If you were a commercial diver, or a very avid current diver, I guess that would be a hard personal choice that you would have to make based on no data. Given the fact that you haven't been diving in 14 years, you might want to find a reward for yourself that doesn't stress the barrier between the ocean and your brain...

Sorry, hope this helps!

Mike