apnea diver
Registered
After 40 years of diving, it was my turn to get SSHL. I want to communicate my experience, the things I learned, and some advice. Disclaimer: I am not a doctor; this is all based on my experience dealing with this serious issue.
1. My case
I was freediving to around 20 feet, when my left ear clogged. I forced a Valsalva and was able to equalize. But when I returned to the surface my left ear felt a bit stuffy. I exited the water and all was fine for 2 days. Then on day 3 I woke up with muffled ear, full hearing loss, and tinnitus. The ENT diagnosed me with SSHL. It happens not only with divers, but many middle-aged people, who forcefully blow their nose, sneeze, or strain.
I started steroids (prednisone 60mg for a week, plus a week tapper off). After one week on prednisone, I got almost half of my hearing back. Then I started Hyperbaric oxygen treatment. I did 15 sessions, 90 min ea, at 2.5 atm, full oxygen. After the hyperbarics I got most of my hearing back. Still some tinnitus but I slowly learn how to deal with it.
2. What likely happened
We suspect that the forced Valsalva caused pressure in the middle ear, thus forcing the eardrum and the oval window out. As a result, the round window has to pull in, as it "decompresses" the cochlea. This probably caused some microscopic fissure on the round window. But it didn't leak much of the cochlea fluid. So I didn't get vertigo.
We didn't do any CT/MRI imaging, because it is not likely to show such a small fissure. Actually, as I found out in my research, even when exploratory surgery is done, the doctor cannot really see a fistula, let alone a tiny fissure. For this reason, some research suggests patching the round and oval window regardless. When the round or oval window tear, it is called a Perilymph Fistula. PLF is a subset of SSHL.
3. Advice for divers
I am not a doctor, but this is what I found out in the course of this ordeal. This was a wakeup call for me after 40 years of diving with zero problems freediving to 100' and scuba diving to 150'. SSHL is quite common in diving. It is well known in the dive community for many years. I searched the ScubaBoard and the SpearBoard (freedivers mainly). There was a plethora of similar cases. They went diving fine, and the next day or day after, they woke up deaf in one ear.
Here is what I learned:
Finally, I am so thankful to the ScubaBoard, because I found out so much info at a time when I was completely lost. Thank you all for sharing your experience, and the MDs on the list for offering valuable advice.
1. My case
I was freediving to around 20 feet, when my left ear clogged. I forced a Valsalva and was able to equalize. But when I returned to the surface my left ear felt a bit stuffy. I exited the water and all was fine for 2 days. Then on day 3 I woke up with muffled ear, full hearing loss, and tinnitus. The ENT diagnosed me with SSHL. It happens not only with divers, but many middle-aged people, who forcefully blow their nose, sneeze, or strain.
I started steroids (prednisone 60mg for a week, plus a week tapper off). After one week on prednisone, I got almost half of my hearing back. Then I started Hyperbaric oxygen treatment. I did 15 sessions, 90 min ea, at 2.5 atm, full oxygen. After the hyperbarics I got most of my hearing back. Still some tinnitus but I slowly learn how to deal with it.
2. What likely happened
We suspect that the forced Valsalva caused pressure in the middle ear, thus forcing the eardrum and the oval window out. As a result, the round window has to pull in, as it "decompresses" the cochlea. This probably caused some microscopic fissure on the round window. But it didn't leak much of the cochlea fluid. So I didn't get vertigo.
We didn't do any CT/MRI imaging, because it is not likely to show such a small fissure. Actually, as I found out in my research, even when exploratory surgery is done, the doctor cannot really see a fistula, let alone a tiny fissure. For this reason, some research suggests patching the round and oval window regardless. When the round or oval window tear, it is called a Perilymph Fistula. PLF is a subset of SSHL.
3. Advice for divers
I am not a doctor, but this is what I found out in the course of this ordeal. This was a wakeup call for me after 40 years of diving with zero problems freediving to 100' and scuba diving to 150'. SSHL is quite common in diving. It is well known in the dive community for many years. I searched the ScubaBoard and the SpearBoard (freedivers mainly). There was a plethora of similar cases. They went diving fine, and the next day or day after, they woke up deaf in one ear.
Here is what I learned:
- Seek ENT advice ASAP. It is a medical emergency, and the longer you wait, the less likely the recovery. They say you have 2 weeks to do the steroids/hyperbarcis, or the PLF surgery. After that recovery is not guaranteed.
- Avoid the Urgent care and ask your PCP for ENT referral. You must convince your PCP that this is a serious medical emergency.
- If you get SSHL, avoid bending, weights, over-exertion, and pain killers, or decongestants.
- Don't dive with or after a cold.
- Don't force a Valsalva.
- Don't let water in your mask, as it causes snot in your nose which will block your ear tubes.
Finally, I am so thankful to the ScubaBoard, because I found out so much info at a time when I was completely lost. Thank you all for sharing your experience, and the MDs on the list for offering valuable advice.
