Unknown sharp pain in ear, Not pressure related, Help?!

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k4sdi

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Help! I’m trying to get back into diving and I’m having an ear problem for a couple of years now that I can’t seem to figure out! I’ve searched the forums and other internet sites with no luck.

The Short Version…
When I start a dive (or just swimming for that matter) when I tilt my head to the side to allow the air to bubble out of my ears, my right ear is fine, but when the air bubbles out of my left ear and the water rushes in, I feel a horrid debilitating stabbing pain and vertigo. After I come to the surface, it takes a minute or two for the pain to decrease to a tolerable level. After 15 or 20 min, everything is back to normal.
The Long Version…
I’ve been diving for around 10 years now. Two years ago after what seemed like a long winter, I went swimming in a friends pool, swam down to the bottom (3’ or so) and felt this stabbing pain as mentioned above. I thought that maybe I had ruptured an eardrum, but instead of going to the doctor I simply stayed out of the water for a couple of months to let it heal. Four or five months later, I decided to try it again, but as soon as water entered my ear, the same stabbing pain occurred. This time I went to see an ENT. She performed a Tympanometry which she said looked fine. She put me on antibiotics saying that the eardrum looked a little red. Seven months go by before I am brave enough to get in the water, hoping that whatever it was has healed up. However, as soon as water enters my ear canal, that familiar sudden sharp pain and vertigo returns. This time I stay out of the water for over a year.

This winter, my son decides that he wants to dive, sounds to me like it’s time to try this ear thing again. Joining him at a pool session, I take it nice and slow, but again, as soon as water entered my ear canal, the pain hits. The next day I visited a different ENT doctor, who also did a tympanometry with normal results, and said everything looked fine visually. He told me that more than likely it was a squeeze and recommended trying Sudafed and nose spray. (I really don't think its a squeeze) Even though I don’t like the sound of that, I decided to try it that night in the pool. I took it nice and slow, and descended down to the bottom, equalizing constantly, then laid there for over 20 min without any trouble. However, I had been very careful not to tilt my head to let water in my ear canal. Towards the end of my sons class, I decided to have a little fun with him and do a barrel roll, and as soon as I felt the bubbles go out of my ear, that sudden pain returned. I tried the Docs Pro Plugs next, the X-large seemed to fit but when I got in the pool to try it, blub blub blub, water in my ear and pain. The XX-large won’t fit in my ear without forcing it, so I’m a bit afraid to try that.

Just yesterday, while standing in 3 foot of water, I ducked my head under to get my hair wet, and I must have gotten water in my ear, because it happened again! Argh!!!!

Random thoughts and info…
I've NEVER had trouble equalizing in my 10 years diving. I've always been that annoying guy that can flex the roof of my mouth and clear my ears easily.
The pain (possibly less intense?) is not always accompanied by vertigo.

The only thing I can think of next is finding an ENT that specializes in dive medicine, however this would mean some travel. Anyone have any ideas whats going on with my left ear?
 
Yup, sounds like a caloric response, which for some reason is more pronounced on the left side. The caloric response has nothing to do with middle ear equalizing, and tympanometry would be normal. It is the result of cold water stimulating the part of the inner (the horizontal semicircular canal) which causes one inner ear to fire signals to the brain more than the non-stimulated ear. The brain processes these mismatched signals to produce vertigo.

Not sure about the pain, but it may be that there is some sort of acquired or congenital abnormality in the bony shell that covers the semicircular canal on the left side, or possibly other abnormalities of the ear canal that make it easier for cold water to hit that part of the ear. The fact that it is of recent origin suggests something changing in your ear anatomy. A CT scan might help...

If you PM me, and tell me where you are located, I may be able to refer you to an otologist (ear specialist) for this, for a full examination, audiogram, etc... Doesn't really sound like a diving issue at all (that is, not a form of barotrauma), but obviously it would cause problems during diving if you got an attack at depth.
 
I have not tried it and I do not endorse it, but reading your post reminded me of another diver that could not tolerate water in the ear canal and I remember others recommending a special mask/hood combo that is suppose to keep water out. I did a search and I think it is called Pro Ear Mask and Hood.
 
https://www.shearwater.com/products/peregrine/

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