Monday, July 4, 2022

Can Scuba Diving Cause Hearing Loss

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How To Avoid A Damaged Eardrum

Noise-induced hearing loss affecting the diver

When you are scuba diving or freediving, the most common way of damaging your eardrum is by diving with congestion and forcefully equalizing.

To avoid this, you should not dive when you are sick or congested.

However, if you are diving with a bit of congestion, then descend slowly and make sure that you are equalizing early and often. Try to use a descent line or a mooring line to hold onto so you can slowly go down. Let your buddies or dive guide know in advance that you may need more time when descending and communicate with them to signal if you are okay.

Remember to never push it. If you are having trouble equalizing then it is better to abort and end the dive, rather than push it, and damage your ear, thus stopping you from diving for weeks or even months.

Treatment Of Cleft Palate And Lip

The treatment for your childs cleft palate or lip will depend on the severity of the condition. Treatment often involves several surgeries to close the opening and reconstruct the face.

A team of specialists may work with you and your child. For example, if your child has problems with speech because of their cleft, they might work with a speech pathologist. Your childs team may also include a plastic surgeon, an oral surgeon, and/or an orthodontist.

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When To Seek Medical Care For Ear Pain From Diving

The majority of cases of ear pain or squeeze force the diver to abort the dive before the eardrum ruptures. In these cases, symptoms often resolve shortly after the diver reaches the surface. If symptoms continue or the cause of the ear pain is not known, seek medical care. Disorientation, vomiting, and hearing loss are symptoms of a ruptured eardrum and require medical care.

If a ruptured eardrum is present or suspected, the diver should be evaluated in a hospital’s Emergency Department. Transport by car is acceptable. No further dives should be undertaken until the diver is medically cleared.

  • swelling and redness of the eardrum, or
  • a hole in the eardrum.

Hearing loss or facial paralysis may also be present. X-rays and blood tests are not needed.

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Causes Of Swimmers Ear

1. Polluted water

Unfortunately, this can be common when snorkeling in areas where there is heavy tourism activity.

It can also come from using swimming pools that are not cleaned effectively.

Whatever the exact source, this introduces bacteria into the ear canal that can cause an infection.

2. Repeatedly getting ears wet then dry

The tissue inside the ear tends to swell when it gets wet and then reduces back as it dries.

Getting your ears repeatedly wet can lead to the tissue becoming inflamed, which creates small spaces where water gets trapped.

The moist environment allows bacteria to grow and cause an infection.

This can be common if someone is continually getting in and out of the pool or sea.

4. Effects from Waves

Waves constantly slapping water into one ear can irritate the canal sufficiently to make infection possible.

Similarly to getting the canal wet repeatedly, the irritation can cause inflammation, creating trapped spaces for bacteria to grow.

4. Irritating the ear canal with objects

You can easily damage your outer ear canal with objects, including tissue and cotton buds.

Any damage to the ear canal makes infection from snorkeling or swimming more likely.

No matter how your ear feels, sticking anything at all inside the canal is likely to make it worse.

Auditory Complaints In Scuba Divers

Barotrauma

There are a variety of auditory problems reported by SCUBA divers that are related to both the outer and inner ear. The auditory injuries are usually acute in onset, however a small percentage of the population may report chronic disability such as hearing loss and tinnitus. The following section discusses some of the main complaints reported in published work.

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Can Earplugs Help When Diving

Normal earplugs typically do not help. In fact, they can cause more harm than intended. They create airspace that cannot be equalized when diving. This makes them very dangerous and unsafe. Again, we would not recommend earplugs when diving.

However, surfing is a different story. Surfing earplugs are built in a way that keeps water out of the ear. When customized properly, these earplugs also allow for the surfer to still hear sound while wearing these earplugs.

Due to surface tension of water, the earplugs prevent abrupt pressure changes from reaching the eardrum causing pain. It keeps the ear warm, as cold water does not get in touch with the skin on the inside of the ears which would lead to heat loss through the water.

Diving Causes Of Tinnitus

  • TMJ syndrome
  • Middle ear barotrauma
  • Inner ear barotrauma.
  • Round window rupture (Due to elevated pressure blowing this window out into the middle ear0
  • Inner ear decompression accident

Finally, advice from an otolaryngologist familiar with the damage that can occur from diving should be obtained. Self -diagnosis and treatment has no place in the management of tinnitus from diving injuries.

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So Whats The Final Verdict Is Popping Your Ears Bad For You

Well, first, lets talk about what happens when you pop your ears:

A long, thin tube called the Eustachian tube connects the back of your nose and the middle ear . When you pop your ears, you are actually pushing air from your nose, up your Eustachian tube and behind your eardrums. This is why when air pressure suddenly changes for example in an airplane, popping your ears can help with that muffled feeling because it equalizes the pressure on both sides of the eardrum.

With this knowledge, there are two big reasons you may have heard that its bad to pop your ears.

One, because the Eustachian tube is connected to the nose, it is also in the presence of all the liquids and bacteria that exist inside your nose. While normally this isnt a problem, popping your ears when youre sick can push not only air, but also spit, snot and other unwanted liquids into your middle ear, increasing the risk of an ear infection.

Second, holding your nose and blowing out is the best way to pop your ears but if you arent careful, you can blow out your eardrums. This is especially a concern for people with damaged or weakened eardrums.

Popping your ears can open up your Eustachian tubes, but even if you dont pop them, your Eustachian tubes will also open naturally. In fact, they should open 6-10 times every minute!

If you are having trouble with your ears, give us a call at Arizona Hearing Center at 602-307-9919 so we can schedule a hearing test for you.

Causes Of Inner Ear Barotrauma

Dr. Kang’s SCUBA Diving stories – Round Window Rupture

Damage to either the round window or the oval window is classified as an inner ear barotrauma.

Improper equalization techniques or the inability to equalize the ears are the most common causes of an inner ear barotrauma. Forceful Valsalva maneuvers can cause a round window rupture if executed when the eustachian tubes are congested or blocked. Blowing hard with a blocked eustachian tube increases the pressure of the inner ear fluid which can blow out the round window.

Continuing a descent while unable to equalize can lead to an inner ear barotrauma. As the eardrum flexes inwards, the pressure is transferred directly to the oval window via the ossicles, causing the oval window to flex inward in conjunction with the eardrum. At this point, the ossicles either press through the oval window or the increased pressure in the inner ear from the oval window pressing in causes the round window to bulge out and burst.

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Can Diving Make You Deaf

UW360 and the DAN Asia Pacific Medical Team look further into how diving can affect your hearing

The most common injuries divers experience are ear injuries. Not fully understanding the anatomy of the ear, or pushing your diving safety limits, can greatly enhance your risk of encountering an issue. UW360, along with the Divers Alert Network Asia-Pacific Medical Team, investigate the causes and symptoms of ear injuries when diving and how to reduce the risks.

Ear Injuries and Potential Risks

An ear injury can lead to complete or partial hearing loss, which can occur for a variety of reasons. There are several diving-related causes, including barotrauma, decompression sickness , and damage to the inner ear.

Hearing loss can be classified as conductive or sensorineural:

  • Conductive hearing loss involves the ear canal, eardrum and tiny bones of the middle-ear ossicles these anatomical components mechanically conduct sound to the inner ear, where electrical signals are generated
  • Sensorineural hearing loss involves the brain, the eighth cranial nerve or the inner ear

Causes, Signs, and Lessons

The more extreme diving-related ear injury, hearing loss, is mainly limited to commercial divers exposed to loud noises and to divers who have experienced barotrauma of the ear. Recreational divers who equalise appropriately and dive without any ear injuries are often not at risk of losing their hearing. The onus falls on the diver themselves: Are they fit to dive?

Eustachian Tube Problems Related To Changes In Altitude

It is common for people who have Eustachian tube problems to have difficulty equalizing middle ear pressure when flying. Pressure changes occur rapidly during an airplanes takeoff and landing procedures: when an aircraft takes off, the atmospheric pressure decreases, increasing middle ear air pressure. When it descends, atmospheric pressure increases, decreasing middle ear pressure. Discomfort is more commonly felt as a plane lands, but can be uncomfortable at any point in a flight if the cabin pressure changes.

There are many ways people can prevent Eustachian tube problems associated with flying, including:

  • Avoiding high-risk situations. People who are suffering from acute upper respiratory ailments, such as a common cold, severe allergies, or sinus infections, should avoid flying.
  • Taking a decongestant. People who have chronic Eustachian tube problems can prepare for air travel ahead of time by taking Sudafed tablets according to package directions the day before the flight.
  • Using nasal spray. Travelers should pack a plastic squeeze bottle of 1/4 percent NeoSynephrine or Afrin nasal spray in their carry-on luggage. Travelers should use the nasal spray once according to package directions shortly before boarding, and again forty-five minutes before the plane is due to land.
  • NOTE: Patients who have had a middle ear ventilation tube placed in their eardrum should not need to follow any of these precautions.

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    How Long Does It Take To Recover From Tinnitus After Scuba Diving

    If youre suffering from tinnitus after a scuba dive, unfortunately, there is no set period of time when you expect the ringing or muffled sound to stop. For most divers, provided they follow the instructions of the medical practitioner, the symptoms will go away within 16 to 48 hours.

    There have been some extreme cases when hearing loss can occur and lead to tinnitus. If this happens, then it can cause long-term issues. But sadly, these symptoms can last for six months or more. It can be commonly mistaken that you are going deaf or have another medical problem, but this is generally not the case.

    The best way to recover is to avoid scuba diving again while youre suffering from the condition and prevent any exposure to loud noises. Both of these can trigger the ringing to occur. Often most people will wear earplugs to protect their ears while they are recovering from tinnitus.

    How To Fix A Perforated Eardrum

    Do Ear Plugs Help When Scuba Diving? (What Causes Diving ...

    Time will usually heal a damaged eardrum. The usual recommendation is 6 weeks, but you should check with your doctor who can refer you to an ENT specialist. They will be able to see inside of your ear with a camera and light to ensure the eardrum has completely healed up.

    You should be keeping the ear dry and clean. For example no swimming, snorkeling or other water activities. You may also need to keep it covered during your shower.

    The ENT may recommend antibiotics or eardrops to combat existing infections. If you have pain from the perforated eardrum, the ENT may also recommend over the counter pain-killers.

    In severe cases, the ENT may suggest surgery on your eardrum. This can involve placing a patch over the eardrum to assist in healing. The doctor may also attach a piece of your own tissue to rebuild the damaged eardrum.

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    Changes In Altitude And Ear Pressure

    There can be a pressure difference between the outside air and the environment within your middle ear space. Most of the time, the pressure in the middle ear is similar to the pressure outside of the ear. The difference is small enough that you dont experience any discomfort or sensations.

    But, when you increase in altitude , then the outside air pressure decreases but the middle ear pressure remains the same. The changes cause the sealed air in the middle ear to expand.

    As a result, pressure is placed on the eardrum. You will feel some discomfort and the desire to pop your ears. Some people find it harder to hear since the eardrum pressure affects the way sound is transmitted through the ears. This sensation often causes you to feel like your ears are plugged.

    Scuba Diving After Perforated Eardrum

    Scuba diving involves equalizing the dead air space of a middle ear, to match the atmospheric pressure of water. This means both spaces are equal and you wont feel pain as you go under more pressure from the water. If you have a perforated eardrum, then water can enter the damaged eardrum, and your middle ear is no longer a dead air space.

    This is not ideal for scuba diving as while you wont need to equalize your ears anymore, it can cause lasting damage to your ears, your sense of balance, and your hearing. You will most likely get an ear infection that can be incredibly painful.

    Find out the Different Ways to Equalize your Ears and why the Toynbee Maneuver is one of the easiest and safest methods to equalize your ears.

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    In This Video Ross Hauser Md Discusses General Problems Of Ear Pain Ear Fullness Sound Sensitivity And Hearing Problems

    Below is the transcript summary and explanatory notes:

    • As the video starts, Dr. Hauser makes a connection between cervical spine/neck instability and cause problems related to the ear and hearing.
    • Our website has numerous articles on hearing problems as they related to cervical spine instability and chronic neck pain and dysfunction. Each article is supported by updated medical research and citation. These articles include:

    Otic And Sinus Barotrauma

    Tinnitus and Hearing Loss

    Barotrauma to the middle or inner ear can occur during the descent or ascent phases of the dive and may cause vertigo and other neurologic symptoms.25,7 Middle ear barotrauma of descent is the most common type of diving injury and may involve hemorrhage and rupture of the tympanic membrane. Symptoms include the acute onset of pain, vertigo and conductive hearing loss that lateralizes to the affected side during the Weber’s test. In severe cases , increased pressure in the middle ear can cause reversible weakness of the facial nerve and Bell’s palsy .8

    Vertigo can also be induced if barotrauma differentially affects the two vestibular organs . The vertigo resolves after pressure equalization occurs. Treatment of middle ear barotrauma involves decongestants , antihistamines, analgesics and antibiotics in patients with otorrhea and perforation.2,4,7

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    What Is A Perforated Eardrum

    A perforated eardrum or ruptured eardrum is when there is a hole or tear in the thin tissue that separates your ear canal from your middle ear.

    The eardrum does two important things for your ears. The thin skin senses vibrating sound waves and converts vibrations into nerve impulses that tells your brain that there is a sound. This allows you to hear.

    The eardrum also protects the middle ear from bacteria as well as water and foreign objects. Normally, the middle ear should be clean and sterile. But when the eardrum is broken, bacteria can get into the middle ear and cause problems.

    Outer And Middle Ear Complaints Of Divers

    Otitis Externa

    Otitis externa is a painful condition with symptoms of redness, swelling, itchiness, and occasionally discharge, that disrupts the healthy lining of the external auditory canal . Being in contact with water is a common factor, with otitis externa occurring five times more often in swimmers than non-swimmers . Water exposure of any kind encourages extraneous flushing of the protective lining of the canal . This creates a perfect habitat for growth of bacteria such as Pseudomonas aeruginosa and Staphylococcus aureus . Muth et al. in their study observed that SCUBA divers are the most commonly affected by this condition especially in warmer climates. Specifically, saturation divers are a commonly affected category of working divers because they maintain little cerumen due to the constant flushing of the EAC, . These divers spend days, sometimes weeks, underwater at a great depth, living within a helium-filled confined space to carry out study on a commercial or industrial basis. Being within such confines can establish a perfect environment for bacteria to develop, in warm constant temperature and humidity. Improvements to saturation divers chamber hygiene has successfully reduced the risks of this in recent years, following the advice given by the Diving Medical Advisory Committee .

    External Auditory Exostoses

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    External Ear Canal Superficial Vessel Rupture

    If you wear a hood while diving, then this injury might occur. The overpressure from scuba diving can cause a blood vessel inside the external ear canal to burst and result in bleeding. If you see any blood, then you should seek medical assistance immediately. You should also continue to monitor for days after diving, as its not uncommon for bleeding to happen days after a dive.

    Like any underwater activity, the body can react differently to the elements. If anything doesnt feel right then, you should stop diving immediately and seek medical help, especially if you notice any bleeding. Ignoring any injuries can cause long-term damage.

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