Very annoying revearse block

[Jon Ward]

Ive been a dive instructor for 6 years and had a bad right ear infection around 6 months ago. Every dive I am getting a revearse block in my right ear from 15 ft to the surface.
I have been seen by two ENT's ..one 3 months ago who gave me antibiotics , ear drops, nose drops ..he basically said that this should cure the problem.. didnt work...and recently another Ent who has put me on nasal spray...still no cure.
I work in the turks and caicos islands so unfortunatly no hi-tec ear problem management devices!
The most recent Ent could not see any external ear problems..and the ear drum looks fine.
Does any one have any advice...apart from seeing a proper specialist in the states?

 

[doctormike]

Ive been a dive instructor for 6 years and had a bad right ear infection around 6 months ago. Every dive I am getting a revearse block in my right ear from 15 ft to the surface.
I have been seen by two ENT's ..one 3 months ago who gave me antibiotics , ear drops, nose drops ..he basically said that this should cure the problem.. didnt work...and recently another Ent who has put me on nasal spray...still no cure.
I work in the turks and caicos islands so unfortunatly no hi-tec ear problem management devices!
The most recent Ent could not see any external ear problems..and the ear drum looks fine.
Does any one have any advice...apart from seeing a proper specialist in the states?

Hi, Jon...

Thanks for writing!

In cases of problems with equalizing during a dive - where there are no ear complaints at baseline - there is rarely anything to see on the physical examination. The issue is generally a functional one involving the Eustachian tube (ET, the tube that connects the middle ear to the back of the nose). In very rare cases, especially if this is a new problem with only one side, there may be something physically impacting on the ET, that may require a nasal endoscopy or even a scan (CT or MRI) to diagnose. Of course, it is also possible that your bad ear infection caused some problems with your ET on that side, and as a dive professional it has been hard for you to take the time off to let your ear heal fully...

As an instructor, I'm sure that you are up to date with all the tricks for equalizing, but just in case there are a few tips that you have missed, this video usually gets posted in these threads.

Good luck, and feel free to PM me if you are coming to the states at any time, I may be able to give you a local referral.

Unfortunately, there aren't really good high tech solutions to this problem... I will say that there isn't a lot of evidence to support the use of nasal medication (sprays or decongestants) in addressing ET issues, even though they are commonly prescribed.

Best,

Mike

 

[TSandM]

I guess the only thing I would add is to ask whether you are sure the problem lies in the ear? Reverse blocks are more common, I believe, with the sinuses. If you have developed a chronic sinusitis, you could be having some degree of obstruction to the sinus drainage passage. Sometimes this requires prolonged antibiotic treatment, and sometimes it ends up needing surgery to open up the sinus and permit it to drain.

 

[Jon Ward]

Thanks both very much for replying..
Today's dive like almost all other felt great until the end where I could feel pressure building on ascent as I approached 20ft..had slight pressure during the safety stop but greater preasure and some air squeeks on a very slow ascent to the surface.

I really dont think its sinus problems...but i could easily be wrong..and It has only been since I had the ear infection and all the pressure feels against the ear drum.

Mike if it means a trip to the states for an internal ear exam and you have some good contacts...then I shall just have to bite the bullet and do it...
Do you think Dan insurance will cover any of it..? When I travelled to Nassau Bahamas to see the ENT...Dan pretty much said no as they only deal with cases 30 days from initial problem...but that claim I havent given up on yet.
It could well be that im not taking enough time dry...with the Ent in Nassau and the abundance of medication, he told me to stay a week out of water...I was lucky enough to stay 2 weeks dry...but no change when i resumed diving.

 

[doctormike]

I really dont think its sinus problems...but i could easily be wrong..and It has only been since I had the ear infection and all the pressure feels against the ear drum.

Yup, if you are feeling the pain in your ear, it is probably an ear squeeze...

Mike if it means a trip to the states for an internal ear exam and you have some good contacts...then I shall just have to bite the bullet and do it...

Sure, I know people in a few scattered places who specialize in ear stuff, but I can usually find an otologist (ENT doc who specializes in ears) near any major city through our academy Web site. Just let me know where in the states you are likely to land...

Do you think Dan insurance will cover any of it..? When I travelled to Nassau Bahamas to see the ENT...Dan pretty much said no as they only deal with cases 30 days from initial problem...

That I couldn't tell you.. I guess it would be in their policy. I have always had good luck with DAN the few times that I had to use their services, but they might not cover chronic injuries, etc...