Reverse ear blocks

[Ardy]

Hi All

I am a 61 year old diver and since my early 50's I have been experiencing reverse blocks, some minor just causing some dizziness and some taking a fair time to get out of the water with upside down moves and all sorts of contortions to try to clear them. Sometimes they are not there at all.

I rarely if ever experience ear problems on the way down.

I have asked a doctor about this and his suggestion is to see a specialist as he had never heard of this before.

Anyone know anything about reverse blocks or experienced them?

regards

Ardy

 

[doctormike]

Hi All

I am a 61 year old diver and since my early 50's I have been experiencing reverse blocks, some minor just causing some dizziness and some taking a fair time to get out of the water with upside down moves and all sorts of contortions to try to clear them. Sometimes they are not there at all.

I rarely if ever experience ear problems on the way down.

I have asked a doctor about this and his suggestion is to see a specialist as he had never heard of this before.

Anyone know anything about reverse blocks or experienced them?

regards

Ardy

Hi, Ardy... welcome to the forum!

The pathophysiology of a reverse block is really just the same as a regular block, but in reverse (hence the name!)... both are caused by the inability of the Eustachian tube (ET) to ventilate the middle ear to accommodate for external pressure changes. The reason that reverse blocks are less common is that it is usually easier to force air out of the middle ear (which needs to happens on ascent) than it is to force it in (which needs to happen on descent). Think of toothpaste squirting out of a tube - even if the ET isn't working that well, eventually the pressure of the air trying to escape from the middle ear will overcome that resistance and find its way out. It is harder to force air up the ET from your airway, that is why many people take a long time to equalize on the way down.

But, as the pilots say "takeoffs are optional, landing is mandatory". If you have a problem equalizing on descent, you can take all the time you need, or just abort the dive. No such option with ascents, you have to get up sooner or later (and usually sooner, if you are carrying your own air!)

While seeing an ENT doctor about this (especially one with dive experience) would be helpful, there aren't necessarily some conditions that cause regular blocks and others that cause reverse squeeze. It usually comes down to good equalization technique (as in Dr. Kay's video) along with medically optimizing your own ET function.

Good luck!

Mike

 

[Ardy]

Thanks Mike - what do you mean by: along with medically optimizing your own ET function

Are suggesting nasal drops or something like that?

regards

 

[doctormike]

Thanks Mike - what do you mean by: along with medically optimizing your own ET function

Are suggesting nasal drops or something like that?

regards

Well, actually... nasal decongestants really don't have much effect on this problem.

I just meant that in addition to learning how to equalize, people who are having trouble with any sort of barotrauma should have a good general ENT exam to make sure that there isn't anything that can be addressed which is causing a problem (allergies, anatomical problems with the ET, chronic ear disease, etc ...)

 

[Ardy]

Thanks Mike I will take this advice.

 

[doctormike]

Thanks Mike I will take this advice.

Sure, no problem... if you have trouble finding an ENT doctor with diving experience, you can call DAN for a referral:

Divers Alert Network : DAN Medical Center : Physicians

 

[gert7to3]

Ardy, what temperature water are you diving in?

I had a reverse block once in cold water and pinholed my eardrum. Since then I have used Doc's Pro Plugs and now a ProEar mask to minimize cold exposure to my ears. I feel there less of a clutch response when I limit water entry into my ears.

Note, when I did suffer the breach of my eardrum, I had the presence of mind to orient the affected ear down and kept expelling air through the ear. This created a bubble and prevented water intrusion. This was probably simpler for me, since I have had a typanoplasty (reconstructed eardrum) and was familiar with being able to push air through my ear. Also what passes for my eardrum is probably less sensitive than an intact eardrum, especially with an initial breach.

I also liberally irrigate my sinuses with saline nasal moisturizing spray. Tank air is really dry. Subjectively, I think keeping my sinuses hydrated has helped with my equalization.

 

[Lee Taylor]

I have on occasional reverse block. I have only found one maneuver that helps me. My description will sound weird but it has helped me open the eustation tube during assent. Try this: Make the assent VERY, VERY, slowly. When starting the assent, start stretching the neck by moving the head slightly side to side and front to rear. Wiggle your jaw and start "popping" your ears. As the assent progresses get more advanced with the process and start tilting your head from side to side as if trying to put your ears on your shoulders. When you hear a "squeeky" sound, you are being successful. The sound is air passing through the eustation tube. If you experience barotrama, do not do a second dive. Do not dive again until it has healed.

 

[Ardy]

Gert it happens in all temp's but I mostly dive in tropical waters ie 24c and above. Sounds like you have had some serious ear issues?

Lee - Thanks for that will try it sounds like it might work. I have tried all sorts of weird efforts to get my ET to open nothing with much success, it normally just takes time, valsalve and moving up and down.

Glad to hear I am not the only one who has reverse blocks.

Ardy