Tinnitus - Can I still Dive?

[Liquid-Playground]

Hello!

Last Saturday whilst snorkeling I seem to have over-equalised my right ear and ever since I have a ringing sensation. I have been to the doctors and using a big torch/telescope thing they can see scar tissue on the ear drum meaning I may have ruptured it but the ear drum itself is nice and shiney and not inflated which is a good sign and they cannot see any other damage. That said I do seem to have a very slight loss of hearing in that ear. There is no pain at all and I don't have any dizzy spells just the annoying ringing sensation.

Next month I will am travelling to Cairns to hopefully dive on the barrier reef - is this a stupid idea? Should I give diving a miss until further tests can be taken place, if any? From what I have read on the web tinnitus is quite difficult to get rid off? Any comments apperciated! Thanks, Mike

 

[Bubbletrubble]

You might be interested in this info on tinnitus hosted on the scuba-doc.com server.

It's great that you've already seen physician(s) regarding the ringing sensation.
I wonder if the eardrum scar tissue you described was from an older injury.
What did the physicians recommend with regard to your future diving endeavors?
Did you consider getting a referral to an ENT with knowledge of dive medicine?
Such a specialist should be able to give a more informed opinion on your condition and give you a better handle on your prognosis.

If I were in your shoes, I'd see a dive-savvy ENT (Divers Alert Network can give a referral to one) and ask for the specialist's opinion on the matter before attempting to dive again. My concern is that subjecting your ears to significant changes in ambient pressure could make the condition worse.

In the future, if you are cleared to dive, you might want to try descending very slowly and using a different ear equalization technique. I'm guessing that you are using a hold-your-nose-and-blow Valsalva technique. I'd recommend trying out some of the passive equalization techniques, since this would decrease the risk of over-pressurization. My favorite is the Roydhouse maneuver. Check out the link in my sig for Dr. Kay's lecture on "ear fear." He also talks about the various techniques of ear equalization. I'd recommend trying all of them and figuring out which one works best for you. Hope this helps...

 

[Duke Dive Medicine]

Hi Liquid,

How bad is the tinnitus? Has it gotten any better or worse? Your statement that you "over-equalised" your right ear and have had a ringing sensation and hearing loss ever since is concerning for perilymph fistula, which is a tear in part of the cochlea in the inner ear. PLF can result from a vigorous valsalva maneuver when air overpressurizes the middle ear. It doesn't necessarily cause vertigo, so damage to your inner ear can't be ruled out based on absence of vertigo.

I concur with Bubbletrubble in that you really need to see an ENT physician who has expertise in diving. If you do have a PLF that's still healing and you go diving with it, you could do further harm to your inner ear. Make sure you give the ENT all the detail that you can.

Best regards,
DDM

 

[Bubbletrubble]

@Duke Dive Medicine: Yeah, I was thinking that it would be good to rule out round window rupture. FWIW, it's very encouraging that the OP denies dizziness and didn't mention any lack-of-balance issues since this rules out a handful of more serious conditions. An ENT would almost certainly explore this more fully, i.e., check for exercise-induced dizziness, arrange for a fistula test (maybe).

 

[Duke Dive Medicine]

Rgr. Hopefully he follows up. BTW, thanks for the link to the Bigley/Hull article in that other thread.