Sudden and complete hearing loss from freediving. No "pop," no pain but now deaf in one ear for more than a week.

[doctormike]

Thanks so much for the update! It sounds like things are moving in the right direction.. hang in there, and keep us posted.

 

[TNEngineer]

Any improvement is progress! Might be a slow process which will try your patience, but take Yes for an answer even if it's slow. Thank you for keeping us updated!

 

[Duke Dive Medicine]

Giving a bit of a belated update. Coming up on nearly three weeks post surgery now.

The surgery itself went fine. I was asked to show up at 8am with surgery scheduled for 10am. Fasted (not even any water) from 8pm the night before. Unfortunately the surgeon's first case of the day took a lot longer than planned so we got to know one of the nurses very well--he kind of kept us company while waiting. Surgery finally started around 1pm. Had 8mg dexamethasone given via IV a bit before the surgery. I wasn't sure if it was to reduce potential post-operative inflammation or as an anti-emetic. Maybe both? Surgery took just about 2 hours total.

I had originally assumed that the surgeon would be cutting my eardrum to access the inner ear, but it turns out that he cuts into the skin around the eardrum and then sort of lifts the eardrum out of the way. He did find a fistula and leakage from the oval window. Just in case, he grafted patches over both the oval and round windows, taking a couple of patches of skin from inside my outer ear to use for the grafts. Most of this was relayed to me by my wife later as I was pretty out of it after the anesthesia.

The first week after the surgery I had to keep a bunch of what my surgeon referred to as "packing material" in my outer ear to help the incision heal. Put antibiotic drops on it twice a day. Pretty much like having an extremely effective ear plug in my bad ear. Due to no sound coming through, tinnitus was pretty bad, but I was hopeful as I could now hear the movement of my jaw when chewing--that hadn't been something I could hear at all before.

After a week I had a follow-up to take out the packing material. When it all came out it almost felt like I could hear again like before the incident, but it was just perceptual--taking the "plug" out of my ear was such a relief I temporarily felt like I could hear again. Driving home from the clinic I realized the radio in the car sounded about as bad as it did before. However, I do seem to have regained some of the high frequencies. Sounds seem to have a sort of metaIlic ring to them now. Human voices and quite a bit of music is still muffled, but my left ear does seem to be working a bit better.

My surgeon said that it's likely to take several months for improvement to show. I haven't been scheduled for an actual audiogram until late December, but I've been using the Mimi app and my AirPods Pro to do self-administered audiogram testing--I have a bunch of previous testing from before the surgery, so even if the tests may not mean much as an absolute measure, I can at least look at them relative to previous results. From what I can tell, I've regained a bit in the midrange (at the 1Khz band) but still exhibit severe loss at 500Hz. The tinnitus really interferes with my ability to hear the tones for the audiogram measurements.

I do feel like I'm having bits and pieces of improvement here and there, kind of two steps forward one step back. I applied my audiogram to my phone's audio settings and used that to set up my left AirPod in transparency mode. Crank up the gain and it's sort of like a hearing aid. Used it to watch a movie with family a few nights back, and I realized when I went to bed that the tinnitus was greatly reduced. That sort of carried over into the next day but I eventually reverted back to the incessant whine. Gives me hope that things can change, though.

Glad to hear that you've seen some improvement! I'm assuming by cranking up the gain on your AirPod you meant that you increased the volume just enough to hear better This makes sense if the tinnitus is directly tied to hearing loss.

Best regards,
DDM

 

[apnea diver]

Chris b, wishing you all the best. Please keep us posted with your progress.
Questions:
1. How come the Audiogram test didn't specify the cause of the problem? In Audiogram a middle ear problem is usually noted as a bone conduction issue, vs. an inner ear problem like SSHL. Without this info your ENT had to do exploratory surgery to confirm the PLF.
2. You didn't say if you had dizziness, which is a common symptom of PLF, and would make it easier to diagnose.

In my case, in a recent shallow freedive in 20" I had difficulty in equalizing my left ear. After surfacing, I felt some ear fullness, but it went away after I exited the water. The next 2 days all seemed fine. But the 3rd day I woke up with stuffy left ear, hearing loss, and tinnitus. Went to Urgent care, they found nothing visible, so suggested decongestants. After 3 days of the same symptoms, I went to a well rated ENT. He saw no visible fluid behind the eardrum, using a flashlight. He started me in steroids (prednisone) 60 mg per day. Tomorrow is my Audiogram test. My ENT suspects SSHL not associated with diving. But I want to make sure it is not PLF. It is rather strange that it happened 3 days after my diving.

 

[Duke Dive Medicine]

Chris b, wishing you all the best. Please keep us posted with your progress.
Questions:
1. How come the Audiogram test didn't specify the cause of the problem? In Audiogram a middle ear problem is usually noted as a bone conduction issue, vs. an inner ear problem like SSHL. Without this info your ENT had to do exploratory surgery to confirm the PLF.

The only way to confirm PLF is via surgery. An audiogram alone can't determine conductive vs. sensorineural hearing loss since it only measures hearing acuity, though there are other tests that are often done along with an audiogram that can. Even these are not diagnostic for PLF.

In my case, in a recent shallow freedive in 20" I had difficulty in equalizing my left ear. After surfacing, I felt some ear fullness, but it went away after I exited the water. The next 2 days all seemed fine. But the 3rd day I woke up with stuffy left ear, hearing loss, and tinnitus. Went to Urgent care, they found nothing visible, so suggested decongestants. After 3 days of the same symptoms, I went to a well rated ENT. He saw no visible fluid behind the eardrum, using a flashlight. He started me in steroids (prednisone) 60 mg per day. Tomorrow is my Audiogram test. My ENT suspects SSHL not associated with diving. But I want to make sure it is not PLF. It is rather strange that it happened 3 days after my diving.

SSNHL can happen coincidentally with diving (see @TNEngineer 's story about his wife earlier in the thread), but if it happens after difficulty equalizing, inner ear barotrauma needs to be ruled out. Where in California are you?

Best regards,
DDM

 

[apnea diver]

The only way to confirm PLF is via surgery. An audiogram alone can't determine conductive vs. sensorineural hearing loss since it only measures hearing acuity, though there are other tests that are often done along with an audiogram that can.


SSNHL can happen coincidentally with diving (see @TNEngineer 's story about his wife earlier in the thread), but if it happens after difficulty equalizing, inner ear barotrauma needs to be ruled out. Where in California are you?

Best regards,
DDM

I am in Los Angeles.

 

[Duke Dive Medicine]

I am in Los Angeles.

DM sent.