What causes ear pain after diving. How to prevent ear barotrauma while scuba diving. What are the symptoms of middle ear barotrauma. How is ear squeeze treated in divers. When to seek medical attention for ear pain after diving. How long does it take to recover from ear barotrauma. Can you dive with a history of ear problems.

Understanding Ear Barotrauma: A Common Diving Injury

Ear barotrauma, also known as ear squeeze, is one of the most prevalent injuries experienced by divers. It occurs when the pressure in the middle ear cavity fails to equalize with the surrounding ambient pressure, leading to discomfort and potential damage to the ear structures. This condition can affect divers during descent, ascent, or even while flying after diving.

To comprehend ear barotrauma fully, it’s essential to understand the anatomy of the ear and how it responds to pressure changes.

Anatomy of the Ear

The human ear consists of three main sections:

1. External ear: Includes the visible part of the ear (pinna) and the ear canal leading to the eardrum.
2. Middle ear: An air-filled cavity between the eardrum and the inner ear, containing three small bones called ossicles.
3. Inner ear: Houses the cochlea (responsible for hearing) and the vestibular system (responsible for balance).

The middle ear is particularly susceptible to barotrauma due to its air-filled nature. The Eustachian tube, connecting the middle ear to the back of the throat, plays a crucial role in equalizing pressure.

Causes of Ear Barotrauma in Diving

Why does ear barotrauma occur during diving? The primary cause is the failure to equalize pressure in the middle ear with the increasing ambient pressure as a diver descends. This pressure differential can lead to various complications.

Factors Contributing to Ear Barotrauma

• Eustachian tube dysfunction
• Congestion or inflammation in the nasal passages
• Rapid descent without proper equalization techniques
• Pre-existing ear conditions
• Inexperience or improper diving techniques

Understanding these factors can help divers take preventive measures and reduce their risk of experiencing ear barotrauma.

Recognizing the Symptoms of Ear Barotrauma

How can divers identify ear barotrauma? The symptoms can range from mild discomfort to severe pain and hearing loss. Recognizing these signs early is crucial for preventing further damage.

Common Symptoms

• Ear pain or fullness
• Muffled hearing or hearing loss
• Tinnitus (ringing in the ears)
• Vertigo or dizziness
• Sensation of ear blockage
• In severe cases, rupture of the eardrum

Is ear pain always indicative of barotrauma? While ear pain is a common symptom, it’s important to note that not all ear discomfort during diving is due to barotrauma. However, persistent or severe pain should always be evaluated by a medical professional.

Prevention Strategies for Ear Barotrauma

Preventing ear barotrauma is crucial for safe and enjoyable diving experiences. By implementing proper techniques and precautions, divers can significantly reduce their risk of experiencing this painful condition.

Equalization Techniques

What are the most effective methods for equalizing ear pressure while diving? Several techniques can help divers equalize the pressure in their middle ears:

1. Valsalva Maneuver: Gently blowing against pinched nostrils
2. Toynbee Maneuver: Swallowing while pinching the nose
3. Frenzel Maneuver: Using the tongue and throat muscles to push air into the Eustachian tubes
4. Voluntary Tubal Opening: Tensing the muscles in the soft palate and throat
5. Edmonds Technique: A combination of Valsalva and jaw movement

Can these techniques be practiced outside of diving? Yes, divers can practice these equalization methods on land to improve their technique and familiarity before applying them underwater.

Pre-Dive Precautions

• Avoid diving with a cold, allergies, or sinus infections
• Stay well-hydrated before and during dive trips
• Consider using decongestants or antihistamines if prone to congestion (consult a doctor first)
• Perform a pre-dive ear check to ensure you can equalize on the surface
• Avoid diving if you’re unable to clear your ears

Treatment Options for Ear Barotrauma

When ear barotrauma occurs, prompt and appropriate treatment is essential to prevent complications and promote healing. The severity of the condition will determine the necessary treatment approach.

Immediate Actions

• Discontinue diving and ascend slowly if underwater
• Avoid further exposure to pressure changes (including flying)
• Apply a warm compress to the affected ear
• Take over-the-counter pain relievers if needed

Medical Treatments

What medical interventions are available for ear barotrauma? Depending on the severity, a healthcare provider may recommend:

• Decongestants or nasal sprays to reduce swelling
• Antibiotics if an infection is present
• Corticosteroids to reduce inflammation
• In severe cases, surgical intervention may be necessary

How long does recovery from ear barotrauma typically take? Mild cases often resolve within a few days to a week, while more severe cases may require several weeks for full recovery. It’s crucial to follow medical advice and avoid diving until cleared by a healthcare professional.

Long-Term Consequences and Complications

While most cases of ear barotrauma resolve without lasting effects, some divers may experience long-term complications or increased susceptibility to future episodes.

Potential Long-Term Effects

• Chronic Eustachian tube dysfunction
• Recurrent middle ear infections
• Tympanic membrane perforation
• Sensorineural hearing loss
• Tinnitus
• Vertigo or balance issues

Can divers with a history of ear problems continue diving? While many divers with previous ear issues can return to diving, it’s essential to consult with a diving medicine specialist or ENT doctor for personalized advice and clearance.

Special Considerations for Different Diving Environments

The risk and management of ear barotrauma can vary depending on the diving environment and conditions. Understanding these differences can help divers adapt their equalization techniques and precautions accordingly.

Freshwater vs. Saltwater Diving

Does the type of water affect ear barotrauma risk? While the basic principles of pressure equalization remain the same, there are some differences to consider:

• Saltwater diving may lead to more irritation if water enters the ear canal
• Freshwater environments might have different microbial profiles, potentially affecting infection risk if barotrauma occurs
• The buoyancy differences between fresh and saltwater can affect ascent and descent rates, indirectly impacting equalization needs

Altitude Diving

How does altitude affect ear barotrauma risk in diving? Diving at higher altitudes presents unique challenges:

• Lower atmospheric pressure at altitude can make equalization more difficult
• Rapid pressure changes during ascent to altitude before or after diving can increase barotrauma risk
• Divers may need to adjust their equalization techniques and dive profiles for altitude conditions

Divers planning to dive at altitude or travel to altitude after diving should be aware of these factors and consult dive tables or computers specifically designed for altitude diving.

Technological Advancements in Preventing and Managing Ear Barotrauma

As diving technology continues to evolve, new tools and techniques are emerging to help divers prevent and manage ear barotrauma more effectively.

Innovative Diving Equipment

• Advanced dive computers with customizable ascent rate alarms
• Specialized ear plugs designed for diving that allow pressure equalization while preventing water entry
• Masks with built-in equalization assistance mechanisms

Medical Advancements

What new medical approaches are being developed for ear barotrauma? Recent research has focused on:

• Gene therapy to improve Eustachian tube function
• Advanced imaging techniques for more accurate diagnosis of middle ear issues
• Novel drug delivery systems for targeted treatment of ear inflammation

While many of these advancements are still in development or early stages of implementation, they offer promising prospects for improving diver safety and comfort in the future.

Training and Education: Key to Preventing Ear Barotrauma

Proper training and education play a crucial role in preventing ear barotrauma among divers. Understanding the physiology of diving and practicing proper techniques can significantly reduce the risk of injury.

Importance of Comprehensive Dive Training

• Thorough instruction on equalization techniques during initial dive certification
• Emphasis on recognizing early signs of equalization problems
• Practice sessions for equalization in controlled environments
• Education on the risks and consequences of pushing through equalization difficulties

Continuing Education for Divers

How can experienced divers continue to improve their knowledge and skills related to ear health? Several options are available:

• Advanced buoyancy control courses to improve ascent and descent control
• Workshops focused specifically on ear equalization techniques
• Dive physiology seminars to deepen understanding of pressure-related injuries
• Regular refresher courses to reinforce best practices and learn about new developments

By prioritizing ongoing education and skill development, divers can enhance their ability to prevent ear barotrauma and enjoy safer, more comfortable diving experiences.

The Role of Pre-Dive Medical Assessments

Regular medical check-ups and pre-dive assessments can play a significant role in preventing ear barotrauma and other diving-related injuries. These evaluations can help identify potential risk factors and address them before they lead to problems underwater.

Components of a Comprehensive Dive Medical

• Detailed medical history, including any previous ear or sinus issues
• Physical examination of the ears, nose, and throat
• Hearing tests to establish baseline function
• Tympanometry to assess eardrum and middle ear function
• Eustachian tube function tests

Frequency of Dive Medicals

How often should divers undergo medical assessments? The recommended frequency can vary based on several factors:

• Age: Older divers may benefit from more frequent check-ups
• Diving frequency: Regular divers should consider annual assessments
• Medical history: Those with previous ear issues may need more frequent evaluations
• Type of diving: Technical or professional divers often require more regular assessments

By prioritizing regular medical assessments, divers can catch potential issues early and take appropriate preventive measures, reducing their risk of experiencing ear barotrauma and other diving-related health concerns.

Ear pain after diving? You may have sustained an ear barotrauma!

I recently saw a patient, Ms A who suffered from blocked ears and ear pain after taking her first diving lesson. It occurred during her dive. She was worried that she might have sustained a permanent injury to her ears. She denied any ear discharge, giddiness, headaches or nasal symptoms. She did give a history of having ear discomforts during flights.

On clinical examination, there was a collection of blood in both her middle ears, just behind her ear drums. This resulted in a conductive hearing loss which was confirmed on a hearing test (audiometry). I explained to Ms A that she sustained a barotrauma to her middle ear and reassured her that the blood behind her ear drum (known medically as hemotympanum) will resolve on its own with time.

Picture of Ms A’s right ear drum with blood behind it (reddish hue)

Picture of Ms A’s left ear drum with blood behind it

Picture of a normal left ear canal and ear drum

Upon review in the clinic about a month later, Ms A was happy that her symptoms have resolved and her hearing is now back to normal. A clinical examination showed complete resolution of the blood in her middle ear. She was advised to take precautions to avoid such situation in the future.

What is ear barotrauma?

It is a condition in which one experiences ear symptoms (usually discomfort, blockage, pain or giddiness) as a result of exposure to changes in pressure in the environment (usually from a change in altitude)

What causes ear barotrauma?

The Eustachian tube is a bony-cartilaginous tube that connects the middle ear to the back of the nose (area known as nasopharynx). It helps to equalize the pressure the pressure in the middle ear and that of the outside environment. Maneuvers to actively open the Eustachian tube includes Valsalva maneuver (trying to “pop” your ear by blowing out against a pinched your nose and closed mouth), yawning, chewing and crying.

In ear barotrauma, the Eustachian tube fails to cope with the change in pressure. When this occurs, there is a difference in pressure across the ear drum (look at the figure below). The pressure difference can be large enough to cause blood vessels and ear drum to rupture.

Figure taken from “Koriwchak MJ, Werkhaven JA. Middle ear barotrauma in scuba divers. Journal of Wilderness Medicine, 5, 389-398 (1994)”

Who are at risk of ear barotrauma?

There are 3 main groups of people who might be at risk of ear barotrauma:

1. People with Eustachian tube dysfunction
   People who has problems equalizing their ears during flight or in areas of high altitude (E.g. in a tall building or mountains) are more likely to sustain ear barotrauma. It is likely that their Eustachian tubes are not functioning as efficiently as they should.
2. People with problems with their nose
   As one of the Eustachian tube opening is in the nose, if nasal allergies, colds or sinus infection, you may be more likely to sustain an ear barotrauma.
3. Young children and babies
   Eustachian tubes in children and babies are smaller, less matured and positioned in a way such that they are not as effective as adult Eustachian tubes. Babies and young children in a plane often cry during take off or landing as this helps open their Eustachian tubes to cope with the change in pressure.

What can I do to prevent ear barotrauma?

People at risk of ear barotrauma should avoid exposing themselves to situations that result in a sudden change in atmospheric pressure (E.g. diving, taking frequent airplane flights). If these situations are unavoidable, some precautions that may help include during the change in pressure:

1. Yawning
2. Chewing
3. Taking decongestants or antihistamines half an hour to 1 hour before flight / diving
4. Treat underlying nose problems
5. Ventilation tubes placed in the ear drums for people who fly frequently

What is the treatment for ear barotrauma?

Fortunately, majority of ear barotrauma does not need any treatment and recovers fully on its own. During this period, patients should avoid exposing themselves to significant pressure changes in the environment such as diving or taking a flight.

Middle-Ear Barotrauma (MEBT) – Divers Alert Network

Middle-ear barotrauma (ear squeeze) is the most common dive injury. It occurs when pressure in the air space of the middle ear is not equalized to the ambient pressure. It can cause a ruptured eardrum and can happen either while diving or flying.

Anatomy and Functions of the Ear

The human ear has three distinct sections:

• External ear: This includes the ear itself and the ear canal to the eardrum.
• Middle ear: This is an air-filled cavity between the eardrum and the inner ear. It has three components: the middle-ear cavity, the three ear bones (ossicles) and the mastoid process.
• Inner ear: The inner ear is a sensory organ. It is part of the central nervous system, and it has two functions:
  • Auditory: The cochlea turns soundwaves into electrical impulses for the brain.
  • Balance, orientation and acceleration: The canals provide some of our control of balance and position and help detect acceleration.

Mechanisms of Injury

The air pressure in the tympanic cavity — an air-filled space in the middle ear — must be equalized with the pressure of the surrounding environment. The Eustachian tube connects the throat with the tympanic cavity and provides passage for gas when pressure equalization is needed. This equalization normally occurs with little or no effort. Various maneuvers, such as swallowing or yawning, can facilitate the process.

An obstruction in the Eustachian tube can lead to an inability to achieve equalization, particularly during descent, when the pressure changes quickly. If the pressure in the tympanic cavity is lower than the pressure of the surrounding tissue, this imbalance results in negative pressure (a relative vacuum) in the middle-ear space. It causes tissue to swell, the eardrum to bulge inward, leakage of fluid and bleeding of ruptured vessels. At a certain point an active attempt to equalize will be futile, and a forceful Valsalva maneuver may injure the inner ear. Eventually the eardrum may rupture; this is likely to bring relief from the pain associated with MEBT, but it is an outcome to avoid if possible.

Often the injury is serious enough that it causes rupture of the eardrum, tympanic membrane rupture or inner ear barotrauma.

Factors that can contribute to the development of MEBT include the common cold, allergies or inflammation — conditions that can cause swelling and may block the Eustachian tubes. Poor equalization techniques or too rapid descent may also contribute to the development of MEBT.

Manifestations

Divers who cannot equalize middle-ear pressure during descent will first feel discomfort in their ears (clogged or stuffed ears) that may progress to severe pain. Further descent only intensifies the ear pain, which is soon followed by a serous fluid buildup and bleeding in the middle ear. With further descent, the eardrum may rupture, providing pain relief; this rupture may cause vertigo and hearing loss. Exposure of the normally sterile middle ear to infection from a mixture of pathogens from the non-sterile contents of the ear canal and surrounding water may result in a middle-ear infection.

Signs and Symptoms

• A feeling of clogged or stuffed ears
• Ear discomfort or pain
• Pain increases with descent during diving
• Fluid buildup and bleeding
• Eardrum rupture, leading to vertigo and hearing loss

Prevention

• Do not dive when congested.
• Refrain from diving when feeling popping or crackling in your ears, or if you have a feeling of fullness in your ears after diving.
• Learn and use proper equalization techniques.

First Aid

• Use a nasal decongestant spray or drops. This might reduce the swelling of the mucous membranes, which may help to open the Eustachian tubes and drain the fluid from the middle ear.
• Do not put any drops in your ear canal. If the tympanic membrane is ruptured, this might make things worse.
• Seek professional medical evaluation. Any doctor should be able to help, regardless of any dive medicine knowledge or training.

Implications for Diving

For the Diver

• You can consider a return to diving if a physician determines that the injury has healed, and the Eustachian tube is functional.
• Do not neglect these injuries. Some of the complications could negatively affect you for the rest of your life.
• Return to your physician if you have worsening pain, fever or discharge. These may indicate a middle-ear infection.

For the Dive Operator

• Have the diver evaluated by a medical professional in a timely fashion.
• Don’t worry about referring them to a doctor with dive medicine experience. An ear, nose and throat (ENT) doctor (otolaryngologist) is ideal for both ear and sinus problems, but your primary care physician can help for most common problems.

For the Physician

• Provide symptomatic treatment (anti-inflammatory drugs, decongestants, mucolytic agents).
  • Prophylactic antibiotic therapy is controversial. Although a middle-ear infection is a plausible secondary complication, this is not always the case in the acute phase.
• Assess tympanic membrane perforation (this is sometimes difficult to recognize).
  • If present, consider referring the patient to an ENT specialist.
  • Use the O’Neill grading system or detail what you observe.
• Assess the vestibular function.
  • Vertigo, nystagmus and/or hearing loss might be suggestive of inner-ear barotrauma. If present, strongly discourage your patient from further diving until properly cleared by a specialist.

Fitness to dive

Do not dive until swelling and inflammation have resolved, and you can adequately equalize, preferably under otoscopic evaluation. Assess why the problem occurred (lack of training, allergy, etc.) and address each factor. If you are unable to equalize, then you may consider ENT consultation. The inability to equalize properly is disqualifying.

Note: Do not dive with earplugs, as this may cause external-ear barotrauma.

Ear Pressure Injury & Scuba Diving – Atlanta | Sinus Sleep Thyroid Hearing

Ear problems are some of the most common medical issues affecting scuba divers, swimmers and freedivers.  Scuba diving is an awesome sport with “professionals and amateurs but no competition”.  However as every diver knows, the issues affecting ear pressure is amongst the toughest challenges for enjoyable and successful scuba diving.

When diving under water the pressure exerted on the ear drum become immense.  A well functioning eustachian tube is necessary to change depths quickly.  New divers often discover that descending below just a few feet can be very painful if the ears have not cleared.  And once the “squeeze” starts its even more difficult to get the ears to clear easily.   At a certain pressure gradient, clearing the ears becomes basically impossible.  The rule of thumb for diving is “clear your ears early and often”.  On descending the first 20 feet or so the pressure change is noticeable enough to need to clear your ears ever foot or two, descending slowly.  Some people’s ears clear more or less automatically, other divers really have to focus on this with a number of eustachian tube clearing maneuvers. New procedures, such as eustachian tube balloon dilation, may be helpful to make it easier to clear the ears

Failure to clear the ears with air through the eustachian tubes may quickly result in hemorrhage into the ear space as a result of the pressure change.  Essentially the relatively imbalanced lower pressure in the middle ear will get balanced either by the Eustachian tubes clearing it with air (the right way), with blood or body fluid spilling inside the ear, or with a hole in the eardrum forming.

The photo below is an eardrum with dark coagulated blood and air bubbles behind it that happened to a diver who had significant pain starting at only about 8feet of depth.   There is a normal eardrum for comparison also.

Eardrum with hemorrhage in middle ear.Versus normal healthy eardrum.

If you develop ear pain while diving, have lingering stuffiness after diving or experience vertigo please visit a doctor to have things checked out.  An ear nose and throat with full hearing test capabilities is your best bet.  You really should not continue to dive if ear pressure or hearing loss is present.  Continuing to dive can be dangerous for your ear health (permanent hearing loss or infections are possible) and can even pose a drowning risk as you may be at risk for for vertigo/disorientation when under water.

How to Clear Blocked Ears

Ear woes are the No. 1 reason divers pull the plug on a dive, and in extreme cases, the sport itself. But with a few tricks and advanced techniques on how to clear blocked ears, almost anyone can make equalizing easier. In diving, the Valsalva maneuver is often used on descent to equalize the pressure in the middle ear to the ambient pressure. Performed properly — pinching your nose shut while exhaling — most divers can descend without any problems. But for some divers, the technique doesn’t help.

You should never continue with a descent if you are experiencing ear pain. But before you give up on a dive — or diving itself — try these tips on how to clear blocked ears.

Listen for the “pop.” Before you even board the boat, make sure that when you swallow you hear a “pop” in both ears. This tells you both eustachian tubes are opening.

Start early. Several hours before the dive, begin gently equalizing your ears every few minutes. Chewing gum seems to help because it makes you swallow often.

Equalize at the surface. “Prepressurizing” at the surface helps most divers get past the critical first few feet of descent. It may also inflate your eustachian tubes so they are slightly bigger. Not all medical authorities recommend this, however. The lesson here is to pre-pressurize only if it seems to help you, and to pressurize gently.

Descend feet first. Studies have shown a Valsalva maneuver requires 50 percent more force when you’re in a head-down position than head-up.

READ MORE: How to Deal with Seasickness

Look up. Extending your neck tends to open your eustachian tubes.

Use a descent line. Pulling yourself down an anchor or mooring line helps control your descent rate more accurately. A line also helps you stop your descent quickly if you feel pressure.

Stay ahead. Equalize often, trying to maintain a slight positive pressure in your middle ears. Don’t wait until you feel pressure or pain.

Stop if it hurts. Your eustachian tubes are probably locked shut by pressure differential. Ascend a few feet and try equalizing again.

Avoid milk. Some foods, including milk, can increase your mucus production.

Avoid tobacco and alcohol. Both tobacco smoke and alcohol irritate your mucus membranes, promoting more mucus that can block your eustachian tubes.

Keep your mask clear. Water up your nose can irritate your mucus membranes, which then produce more of the stuff that clogs.

READ MORE: How to Stay Warm while Scuba Diving

Alternative Clearing Techniques
There are problems with the traditional Valsalva maneuver: It may not work if the tubes are already locked by a pressure differential, and it’s all too easy to blow hard enough to damage something. Divers who experience difficulty equalizing may find it helpful to master some alternative techniques.

Toynbee Maneuver. With your nostrils pinched or blocked against your mask skirt, swallow. Swallowing pulls open your eustachian tubes while the movement of your tongue, with your nose closed, compresses air against them.

Lowry Technique. A combination of Valsalva and Toynbee: while closing your nostrils, blow and swallow at the same time.

Edmonds Technique. While tensing the soft palate and throat muscles and pushing the jaw forward and down, do a Valsalva Maneuver.

Frenzel Maneuver. Close your nostrils, and close the back of your throat as if straining to lift a weight. Then make the sound of the letter “K.” This forces the back of your tongue upwards, compressing air against the openings of your eustachian tubes.

Voluntary Tubal Opening. Tense the muscles of the soft palate and the throat while pushing the jaw forward and down as if starting to yawn. These muscles pull the eustachian tubes open. This requires a lot of practice, but some divers can learn to control those muscles and hold their tubes open for continuous equalization.

Help for Ear Pain While Flying or Diving

Many people experience ear pain when they scuba dive or fly. Some feel that they cannot dive, even in a swimming pool, because they have trouble “clearing” their ears. This ear discomfort is due to pressure changes in the middle ear.

Eustachian Tube Function

The middle ear space operates normally when it is under standard atmospheric pressure, the same pressure in our environment. That pressure is regulated by the Eustachian tube, which ventilates the middle ear space and opens into the back of the nose. The act of breathing through the nose allows air into the middle ear space through the Eustachian tube. This tube opens and closes as needed to allow the correct pressure in the ears.

The Problem with Flying and Diving

Rapid decent while traveling on an airplane or while diving will prevent the Eustachian tubes from opening properly, causing pain from a buildup of negative pressure in the ears. This can lead to middle ear fluid, especially when one is also experiencing symptoms of a cold. In some cases, the pressure buildup can be so bad that it leads to a ruptured eardrum.

The act of swallowing and chewing will help open the Eustachian tube, as it is attached to the muscles on the roof of the mouth. That’s why chewing and swallowing come naturally to us when we feel ear pain or pressure upon airplane landing.

Treatment Options

Although rare, some people do have chronic Eustachian tube problems and no amount of medicine or surgical procedures will give them relief. However, most people will benefit from the following simple treatment options.

For Flying

• If you can avoid it, do not fly when you are sick.
• Take Sudafed before flying.
• Use nasal Afrin spray before flying, and also prior to landing if you are on a long flight. (A note of caution: Use Afrin for a very limited amount of time, as it can be chronically addictive.)
• “EarPlanes,” available at many drugstores, are plugs that can be worn while flying, and specifically landing, to help equalize pressure.
• Drink enough fluids, as the mucous membranes can get sticky when not well hydrated and make ear congestion worse.
• Chew gum while landing.

For Diving

• If you have pain when attempting to dive, do not go down further.
• Try to descend very slowly.
• Taking Sudafed before a dive is very helpful for some people. Make sure the dose is low, 30 mg, as Sudafed can make you a bit jittery and anxious—not a feeling you want when you are under water and trying to relax.

If these techniques do not help, consult your local ENT (ear, nose, and throat doctor).

To find an excellent doctor who is right for you, please call our Physician Referral Service at 866.804.1007.

Scuba Diving Safety – familydoctor.org

Scuba diving is a popular recreational sport. Scuba stands for “Self-Contained Underwater Breathing Apparatus.” When divers scuba dive, they go underwater at depths up to 130 feet. They breathe through a mouthpiece that is attached to a tank of compressed air.

Scuba-certifying agencies offer training for divers, from beginners to experts. Three agencies that offer certification courses are the Professional Association of Diving Instructors (PADI), the National Association of Underwater Instructors (NAUI), and Scuba Schools International (SSI). Basic courses involve classroom instruction as well as training in pools and open-water settings. You can get certified in as little as 5 open-water dives. This allows you to rent equipment, refill tanks, and dive without supervision. However, most agencies recommend you dive in a buddy system, a group of 2 or 3 divers.

Path to safety

Most severe dive-related injuries and deaths happen to divers who are new or go beyond their training or experience. To be safe, always dive within the limits of your experience and level of training. Never try a dive you’re not comfortable with.

Good rules to follow for safe diving include:

• Never dive without a buddy.
• Never dive if you have a cold or are congested in your ears or nose.
• Always plan your dive, and always dive your plan.
• Check your diving equipment to make sure it works. Use the right gear that can handle your planned dive.
• Do not drink alcohol or take drugs before diving.
• Ask your doctor what medicines are to safe to use when diving.
• Ask your doctor how diving can affect your health. It can be dangerous if you have certain health problems.
• Become familiar with the underwater area and its dangers. Learn which fish, coral, and other hazards you should avoid to prevent injury. Be aware of local tides and currents.
• Obey all diving instruction. As you descend, make sure you equalize your ears and mask. At depth, stay inside the parameters of the dive tables and computer. This information helps you avoid decompression sickness.
• Never hold your breath while ascending. Your ascent should be slow and your breathing should be normal.
• Never panic under water. If you become confused or afraid during a dive, stop, try to relax, and think through the problem. Ask for help from your dive buddy or dive master.
• Cave diving is very dangerous. Only divers with proper training and equipment should attempt it.
• If you don’t feel well or if you are in pain after diving, go to the nearest emergency room right away.
• Do not fly for 12 hours after a no-decompression dive, even in a pressurized airplane. If your dive required decompression stops, don’t fly for at least 24 hours.

If you or a dive buddy has an accident while diving, call the Divers Alert Network (DAN) at 919-684-9111. Doctors, nurses, and emergency technicians are available 24 hours a day. They will answer your questions and provide help. If needed, they will direct you to the nearest hyperbaric chamber or appropriate medical facility.

Things to consider

The most common health problem in scuba diving is middle ear “squeezes.” These produce pain in your ears caused by pressure. The deeper you go in the water, the higher the pressure is in contrast with your body. This condition can occur if you are unable to equalize the pressure in your ears as you dive. You can relieve the pressure by yawning, swallowing, or blowing with your nose and mouth closed. This is known as “popping” your ears. Squeezes that affect your inner ear or sinuses are less common.

You can get cuts, scrapes, and other surface injuries. Fish, coral, or other marine life can cause these. Other threats include debris, fishing line, and exposed metal or wood on wrecks.

Below are severe health problems related to scuba diving.

• Inner ear barotrauma. This condition can occur from unbalanced ear pressure or a quick descent in the water. Symptoms include dizziness, nausea, ear pain or ringing, and hearing loss.
• Pulmonary barotrauma. This condition can occur from improper breathing as you ascend to the water’s surface. It also can occur from diving with a respiratory tract infection. Symptoms include chest pain, shortness of breath, and hoarseness. There is a chance you may pass out.
• Decompression sickness (“the bends”). This condition can occur if you ascend from deep water to the surface too quickly. Your body releases nitrogen gas that forms bubbles in your bloodstream. The bubbles can damage your body tissues and block blood vessels. Decompression sickness affects your lungs, brain, and spinal cord. Symptoms include chest pain, joint pain, trouble breathing, and bladder problems. You can become delirious or paralyzed. Signs of severe decompression sickness are dysfunction of the spinal cord, brain, and lungs. Flying after scuba diving can worsen this condition.
• Air embolism. This can occur when bubbles enter your bloodstream and travel to your brain. It can be a type of barotrauma or an effect of the bends. If the bubbles enter a vein, it is called a venous air embolism. If they enter an artery, it is called an arterial air embolism. Milder symptoms include dizziness, confusion, trouble speaking, and numbness. You can suffer from blindness, deafness, seizures, or paralysis. An extreme air embolism can cause a heart attack, stroke, or respiratory failure.

Fortunately, severe health problems from scuba diving are rare. However, you should seek care right away if you have any symptoms listed above. You may require hyperbaric oxygen therapy. This consists of lying in a chamber, or vessel, that has increased pressure. It feels similar to being underwater. The therapy helps to reduce or remove bubbles from your bloodstream.

Questions to ask your doctor

• What health conditions prevent me from scuba diving?
• What medicines can I take while I’m scuba diving?
• What should I do if I feel ill after scuba diving?

Resources

Divers Alert Network

Copyright © American Academy of Family Physicians

This information provides a general overview and may not apply to everyone. Talk to your family doctor to find out if this information applies to you and to get more information on this subject.

How to Avoid diver’s ear and learn to Equalize your ears

Don’t let your ears ruin your dives

You’ve just started your first dive of the day. Everything is going great! You pinch your nose and blow to equalize your ears, but nothing happens. You try again, but same issue.

Your ears starts to hurt…you try again but it’s the same.

So what now?

Accent and end the dive or push on?

No!
It’s time to learn how to equalise the right way!

According to a survey* we did, we discovered that:

• 89% of divers don’t equalize the correct way
• 29% of divers had to stay out of the water for weeks or months due to problems caused by equalizing
• 6.3% of divers have gotten permanent ear damage due to problems equalizing ear pressure

That’s right, you might be Equalizing the wrong way!

The real issue is that the way most of us thought to equalize ears, which happens to be the most common method, is the wrong way to do it.

It’s the Valsalva Maneuver: Pinch your nostrils and blow through your nose. The resulting overpressure in your throat usually forces air up your Eustachian tubes. In a airplane or during a dive it can create the familiar pop in your ears and relieve pressure.

How come it works if it’s the wrong way? It works perfectly fine as long as you keep the tubes open ahead of the pressure changes. However, if you do not equalize your ears early or often enough, the pressure differential can force the soft tissues together, closing the ends of the tubes. Forcing air against these soft tissues just locks them shut.

5 Better ways to Equalize Your Ears

1. Toynbee Maneuver – Pinch Your Nose and Swallow
   With your nostrils pinched or blocked against your mask skirt, swallow. Swallowing pulls open your Eustachian tubes while the movement of your tongue, with your nose closed, compresses air against them.
2. Lowry Technique – Pinch Your Nose, Blow and Swallow
   A combination of Valsalva and Toynbee: while closing your nostrils, blow and swallow at the same time.
3. Edmonds Technique – Pinch Your Nose and Blow and Push Your Jaw Forward
   While tensing the soft palate (the soft tissue at the back of the roof of your mouth) and throat muscles and pushing the jaw forward and down, do a Valsalva maneuver.
4. Frenzel Maneuver – Pinch Your Nose and Make the Sound of the Letter “K”
   Close your nostrils, and close the back of your throat as if straining to lift a weight. Then make the sound of the letter “K.” This forces the back of your tongue upward, compressing air against the openings of your Eustachian tubes.
5. Voluntary Tubal Opening – Tense Your Throat and Push Your Jaw Forward
   Tense the muscles of the soft palate and the throat while pushing the jaw forward and down as if starting to yawn. These muscles pull the Eustachian tubes open. This requires a lot of practice, but some divers can learn to control those muscles and hold their tubes open for continuous equalization.

When to Equalize

Sooner, and more often, than you might think. Most recommend equalizing every two feet (.6 meters) of descent, but often that’s too late. At a fairly slow descent rate of 60 ft (18.288 m) per minute, that’s an equalization every two seconds. Many divers descend much faster and should be equalizing constantly.

The good news: as you go deeper, you’ll have to equalize less often!

10 Quick tips to make equalizing easier

1. Listen for the “pop”
   Before you even board the boat, make sure that when you swallow you hear a “pop” or “click” in both ears. This tells you both Eustachian tubes are open.
2. Start early
   Several hours before your dive, begin gently equalizing your ears every few minutes. “This has great value and is said to help reduce the chances of a block early on descent,” says Dr. Ernest S. Campbell, webmaster of “Diving Medicine Online.” “Chewing gum between dives seems to help,” adds Dr. Campbell.
3. Equalize at the surface
   “Pre-pressurizing” at the surface helps get you past the critical first few feet of descent, where you’re often busy with dumping your BCD and clearing your mask. It may also inflate your Eustachian tubes so they are slightly bigger. The guide here is to pre-pressurize only if it seems to help you and to pressurize gently.
4. Descend feet first
   Air tends to rise up your Eustachian tubes, and fluid-like mucus tends to drain downward. Studies have shown a Valsalva maneuver requires 50 percent more force when you’re in a head-down position than head-up.
5. Look up
   Extending your neck tends to open your Eustachian tubes.
6. Use a descent line
   Pulling yourself down an anchor or mooring line helps control your descent rate  more accurately. Without a line, your descent rate will probably accelerate much more than you realize. A line also helps you stop your descent quickly if you feel pressure, before barotrauma has a chance to occur.
7. Stay ahead
   Equalize often, trying to maintain a slight positive pressure in your middle ears.
8. Stop if it hurts
   Don’t try to push through pain. Your Eustachian tubes are probably locked shut by pressure differential, and the only result will be barotrauma. If your ears begin to hurt, ascend a few feet and try equalizing again.
9. Avoid tobacco and alcohol
   Both tobacco smoke and alcohol irritate your mucus membranes, promoting more mucus that can block your Eustachian tubes.
10. Keep your mask clear
    Water up your nose can irritate your mucus membranes, which then produce more of the stuff that clogs.

90,000 How to get rid of water in the ear: 6 simple ways

Water can get into the ear after swimming in a pool or pond, or taking a bath and, as a rule, flows out naturally, but if this does not happen, there is a high risk of developing an infectious disease.

A good way to prevent water from entering your ear is to wear a cap or earplugs while swimming or swimming, and use a dry towel to clean your ears after getting out of water. If water does get into the ear, the person may experience a tickling sensation that spreads from the ear to the jaw or throat, and may have hearing problems.There are 6 easy ways to get rid of water in your ear:

• you need to twitch your earlobe, while tilting your head to your shoulder. You can also try shaking your head from side to side;
• Another way is to create a vacuum by tilting your head to the side and at the same time pressing your ear tightly with your palm;
• Using a warm compress can also help get rid of water in the ear. Leave the warm compress on for about 30 seconds, then remove it for a minute and then reapply it.The procedure must be repeated 4-5 times. Lying on the side of your body where water has entered your ear can help the water flow out of the ear naturally;
• you can try to evaporate the water in your ear with a hair dryer. In this case, you need to set the weakest drying mode on a hair dryer and keep it at a distance of approximately 30 cm from the ear;
• You can make your own ear solution using a combination of rubbing alcohol and vinegar. The alcohol will help evaporate the water, and the vinegar will help prevent bacteria from spreading. Using a sterile pipette, it is necessary to drop 3-4 drops of the solution into the ear, after 30 seconds tilt the head to the side to allow the solution to flow out;
• You can also make a solution by mixing hydrogen peroxide with water.Drop the solution into the ear using a sterile pipette – 3-4 drops. After 2-3 minutes, tilt your head to the side to allow the fluid to drain.

If water is left in the ear for too long, it can trigger an infection. Typically, an infection occurs when the water that has entered the ear has been contaminated with bacteria. The ear has several defense mechanisms against infections, but if these defenses fail, infection can occur. An excess of moisture in the ear, scratches or cuts in the ear canal, allergies to hair products or jewelry, a history of infections, and other complications can contribute to ear infections.

The Centers for Disease Control and Prevention, USA, recommends not trying to get rid of earwax on your own, as it protects the ear from infection. Anyone who believes that he has a sulfur plug in his ear should seek help from a doctor.

If the problem with the presence of water in the ear cannot be solved on its own within a few days, you should consult a doctor. It is especially important to do this if the ear becomes painful and inflamed, which may indicate an infectious pathology.Untreated ear infections can lead to hearing loss or damage to cartilage and bone.

When an ear infection develops, severe itching and pain may occur. Touching the ear can also cause pain and discharge of pus or fluid. A severe ear infection can lead to fever, swollen lymph nodes in the neck, and pain in the face, neck, or head.

Based on materials from www.medicalnewstoday.com

90,000 Otitis media divers, or how to return healthy from a seaside resort – Into-Sana

The long-awaited vacation time has come.Tired of the scorching sun and labor laws, people plan to go to the shores of seas, oceans and reservoirs. Unfortunately, some ear diseases are closely related to recreation by the water bodies. For example, the incidence of otitis externa in the swimming season (“swimmer’s otitis media”, “diver’s otitis media”) takes on the character of an epidemic. Some of the health problems are associated with objective reasons, some with frivolity. All this will be discussed in this article.

What is this disease?

Acute external diffuse otitis media is an inflammation of the skin of the external auditory canal due to changes in the normal flora or trauma to the soft tissues of the ear canal, followed by infection and inflammation.

A warm and humid environment, scratching of the walls of the external auditory canal, sweating, infection that gets into the ear canal with water when bathing are predisposing factors for the development of the disease. The so-called “diver’s otitis media” occurs after infection with bacteria that live in water bodies in large numbers.

The external auditory canal has its own microflora (staphylococcus, corynebatheria, diphtheroids, etc. ), which, along with earwax, creates the necessary protective layer.When water gets in, earwax is washed out and pathogenic bacteria penetrate into the external auditory canal. A favorable habitat contributes to the multiplication of trapped bacteria, damage to the protective membrane and the development of an inflammatory reaction.

The most common bacterial pathogens of otitis externa are Pseudomonas aeruginosa, Proteus, Staphylococcus aureus. It is also worth remembering that bacteria are not the only cause of otitis media.Fungi Aspergillus, Candida species can also be the cause of the disease in 10-15% of cases (such otitis media is allocated in a special form – otomycosis).

How does the disease manifest itself?

Otitis media is manifested by pain in the ear, itching. The pain can spread to the eyes, teeth, neck and get worse when chewing. Hearing loss is rare. An increase in body temperature (not typical, although possible, but not higher than 38.5 ° C), general weakness, a feeling of fullness, edema, redness may also disturb.

When can you cope with unpleasant symptoms on your own, and when is it necessary to consult a doctor?

In case of symptoms of otitis externa, it is necessary to consult an otolaryngologist to diagnose and prescribe the correct therapy.Attempts to self-medicate can lead to an unfavorable outcome – a protracted course of the disease, the transition to a chronic form.

How to relieve the condition before going to the doctor?

In order to combat pain, you should take an analgesic drug, for example, paracetamol (it also has antipyretic and anti-inflammatory effects). You can put a couple of ear drops with an antiseptic in your ear.

In no case should the ear be warmed up, the self-prepared alcoholic solutions should be instilled, and phyto-suppositories should be injected.

Prevention

The main prevention measure for otitis media in divers is to avoid getting dirty water in the ears. Therefore, you should not swim in the “blooming” reservoirs. If there is any doubt about the purity of the water, you need to close the ear canal when bathing with a cotton swab slightly moistened with petroleum jelly (petroleum jelly perfectly repels water). The cotton ball can only be used once.

Don’t dive. If water does get into the ears, then it should be removed like this: by pulling the auricle up and out, tilt your head to the side and jump or dry the ear canal with a hairdryer.Or treat the external auditory canal with antiseptic solutions (hydrogen peroxide or boric alcohol) – 1-2 drops in each ear canal, and then tilt your head to the side and pull your earlobe so that the water that gets out of the ear flows out along with the antiseptic.

The following advice is addressed to both otitis-prone patients and healthy people who have never had ear problems. Don’t clean your ears the week before bathing! Sulfur kills microorganisms by protecting the ear from pathogenic bacteria.The usefulness of ear sticks is questionable. Excessive effort can damage the skin of the ear canal. Moreover, do not scratch your ear with a safety pin or other objects. Even minor skin damage increases the risk of otitis externa after bathing. It is not recommended to use earplugs while swimming, as this may cause injury.

Adhering to these simple recommendations, the risk of acute external diffuse otitis media during the swimming season is minimized.

Enjoy your stay!

90,000 What to do if water gets into the ear

One has only to relax for a minute, basking in the sun near the reservoir, finally to rest, as one immediately hears crying. Active recreation of children often leads to the ingress of water into the ear, which is not surprising and familiar to many parents. The child cries and complains of pain, telling everyone that during bathing, water flowed into the ear, and he does not know how to remove water from the ear.This problem is faced not only by children, but also by adults. What to do if water gets into your ear? What to do if water gets into the baby’s ear? It is even worse if water enters the ear through the nose while diving or diving.

Causes of water getting into the ears

As statistics show, every third mother faces the problem of water getting into the child’s ear, which indicates that this is a fairly common problem.
The ear consists of three sections: the outer ear, which consists of the outer shell and the auditory tube, which ends with the tympanic membrane, the middle ear with the malleus, incus, stapes and the muscle that strains the tympanic membrane, and the inner ear.Water can accumulate in different departments, depending on this, different symptoms are observed, which means that the treatment will be different.

Causes of frequent inflammation when water gets into the ears:

• age-related anatomical structure, predisposing to inflammatory processes;
• frequent colds;
• frequent crying and sniffing, strong blowing of your nose.

Types of water ingress in the ears

Water ingress in the outer ear

The child experiences discomfort in the ear, complains of gurgling, fluid transfusion, sometimes there is even a sensation of fluid being transfused into the head.The kid complains that water is stuck in his ear.

Giving help:

• Ask the child to jump on the right leg, tilting his head to the right if water gets into the right ear. On the contrary, if there is water in the left ear.
• An effective method is to apply the palm to the ear with force, as if creating a vacuum, and then to take the palm away with force.
• Show your baby how to draw air into his lungs by holding his nose and forcefully blow it out through his ears. This method is used by divers.
• If pain occurs, place the child with the sore ear on a warm bag of salt. The ear will warm up and the water will flow out.

As practice shows, in a person with healthy ears, water cannot penetrate beyond the eardrum, and accordingly, such measures are enough to provide assistance. But if the symptoms have not gone away or the condition has worsened, do not expect serious problems, but seek qualified help from a specialist.

Complications from water entering the ear.

If, after the measures taken, the sensation of water in the ear has not left the child, then there is a complication. When water gets into the ear, the plug swells. The ear is blocked, there is a noise, as a result of the congestion, hearing is reduced – all these symptoms are aggravated when the sulfur plug swells from water and blocks the ear canal. In this case, any of your measures will not help, you need to immediately contact an ENT doctor and wash it out.

Inflammation of the external auditory canal

Pain syndrome, itching and discharge from the ear with an unpleasant odor are added to the described symptoms.It is recommended to immediately consult an ENT doctor, since in this case you cannot do without antibiotics and antiseptics.

Water hit the middle ear

In children, the auditory tube is short and wide and connects to the nose, and since it is flush with the pharynx, any infection can easily enter it. With age, the tube gets narrower and longer, making it harder for infection to enter.

Water enters the middle ear through the nose, stagnating, it causes a lot of trouble: congestion, lumbago.ENT doctors have such a concept as “swimmer’s ear”, which is characterized by all these symptoms.

Giving help:

• Try jumping on one leg with your head tilted toward your stuffy ear (as previously described).
• A cotton wool flagellum inserted into the ear will help absorb liquid. But it is not recommended to remove water with cotton swabs, which, according to ENT doctors, are only harmful.
• Swallow more frequently to relieve symptoms.
• Apply a compress at night.
• The usual pain syndrome and lumbago will be removed with analgin or aspirin.

If, as a result of the above actions, there is no relief, you should immediately consult a doctor , as infection may develop as a result of contamination of dirty water from reservoirs, up to hearing loss.

The advice of an experienced professional will help you at any stage of water getting into your ear, ease your worries and help you sleep peacefully at night.And even more so when it comes to young children who cannot clearly tell about their feelings due to their age. A healthy baby is a restful sleep of a mother!

Sulfur plug | Central Clinic

Ear plug or sulfur plug – this excessive accumulation of sulfur is observed with improper hygiene procedures, excessive synthesis of ear secretions – the plug clogs the ear canal, gradually hardens. Normally, the ear canal clears itself by chewing or swallowing.But after water procedures or in children, due to the structural features, the ear canal can be clogged with a sulfur plug. Sulfur plug is a clot of sulfur, dust, dead cells.

May differ in color and consistency:

• soft, yellow or orange with a pasty structure;
• dark brown, viscosity-like plasticine;
• solid corks are dark brown or black.

Why are traffic jams formed?

One of the most common reasons for the appearance of sulfur plugs is the improper hygienic toilet of the outer ear area, in which earwax is removed only from the outside, and the bulk is compacted and accumulates deep inside the ear canal.

The tendency to the formation of sulfur plugs can be of a genetic nature – the viscous composition of sulfur, active work of the glands, a narrow or very convoluted ear canal can be inherited.

Also, the formation of sulfur plugs can be influenced by such factors as:

• work in rooms with high humidity or dustiness, often diving to a depth;
• old age;
• dermatological pathologies – fungus, eczema, dermatitis;
• high cholesterol content;
• Regular or improper use of headphones and hearing aids;
• otitis media and other inflammatory processes;
• Frequent wearing of headphones may cause ear plugging;
• in addition to sulfur, air congestions can form in the ears, the appearance of which is associated with a change in atmospheric pressure – air travel, ascent high in the mountains;
• Sometimes the cause of discomfort is a water blockage in the ear – formed after diving, bathing.

Doctors do not recommend the use of cotton swabs for cleaning the ears – it is enough to carry out the procedure to remove accumulated sulfur 1-2 times a week, blotting the washed ear with a soft towel.

Symptoms of sulfur plug

For a long time, signs of the presence or formation of a sulfur plug can proceed unnoticed by a person. Most often, unpleasant symptoms intensify after water enters the ear canal – the mass swells, completely fills it. Some signs will help to understand whether there is a sulfur plug:

• ear congestion, most often the pathology is unilateral, sometimes both ears are blocked at the same time;
• impairment of auditory perception – this symptom does not always occur in the presence of sulfur clots;
• noise, rustling in and ringing in the ears;
• a constant feeling of the presence of a foreign body in the ear canal;
• pain and shooting in the ear;
• good audibility of your own voice – autophony;
• Ear pain may indicate an ear plug.

The signs and consistency of sulfur clots in a child are the same as in an adult. Meanwhile, children are more sensitive to the manifestation of discomfort associated with unpleasant ear symptoms, therefore, they begin to actively demonstrate discomfort and pain, which requires an urgent appeal to a pediatric ENT doctor.

When a plug forms near the membrane, dizziness, migraine, yawning, and an unreasonable cough appear. Patients develop symptoms of motion sickness, coordination of movement is impaired.

Methods of ear plug treatment at Central Clinic

Sulfur plug, due to the large accumulation of sulfur, can be seen on your own. To do this, it is enough to look into the ear, pulling it down a little. The doctor diagnoses the ear plug during the initial examination during the otoscopy. Otoscopy is a type of instrumental diagnostics used at the Central Clinic during the initial appointment of an ENT doctor. During the consultation and examination, the doctor collects anamnesis, finds out the possible cause of the disease and prescribes a treatment regimen. It is better to entrust the removal of sulfur clots to an ENT doctor. Only a doctor will be able to assess the severity of the disease and choose a treatment.

There are several methods for removing earwax:

1. Washing of earwax clots with Janet’s syringe. The special design of the syringe avoids the sudden injection of liquid. The syringe is filled with water or saline, the temperature of which is about 37 degrees. The jet is directed along the wall of the ear canal, while the head should be tilted in the direction opposite to the stuffed ear.In this case, for adults, the shell is pulled down a little, for children – a little back and down. After 2-3 minutes, you need to change the position of the head, the doctor removes the sulfur with sterile cotton wool, and a cotton swab soaked in boric acid is temporarily inserted into the ear.
2. The dry method of removal is used in case of large plugs, or in violation of the integrity of the tympanic membrane. The procedure is carried out using an aspirator, which sucks the clot under pressure. Or they use a probe with a hook – they can pierce and get the clot.In order not to injure tissue, the course of manipulation is monitored through a microscope. Hydrogen peroxide will help soften the ear plug Important! Washing is contraindicated in diagnosing pathologies of the tympanic membrane, hearing loss, and a history of chronic otitis media.
3. Self-treatment – is carried out according to the indications of the attending physician according to a specially developed scheme, which the doctor schedules for consultations. To achieve a positive effect, it is necessary to follow all the recommendations, and in case of deterioration of health, be sure to seek help from a specialist.
4. Self-removal of plugs for the treatment of children is categorically not suitable – unpleasant sensations often indicate an infectious process, any unprofessional intervention will cause complications.

How to get rid of the sensation of water in the ear?

• Time to read the article: 1 minute

Everyone at least once in their life has experienced the sensation of water in the ear, which is not so easy to get rid of. Unfortunately, some people choose not to pay attention to this discomfort in the hope that the problem will go away on its own. Such inaction can threaten the emergence of serious complications from the ENT organs.

Sometimes an unpleasant sensation arises after bathing due to the ingress of water, but in some cases, discomfort may indicate the presence of a sulfur plug or even the development of a serious inflammatory process. Before talking about the methods of struggle, first of all, one should understand what exactly provoked the feeling of iridescent water in the ear.

Causes of the sensation of water in the ear

Let’s highlight the main provoking factors of unpleasant sensation:

• water ingress. If an unpleasant symptom arose after swimming in a pool or pond, then most likely water just got into the ear canal. Normally, water should be poured back, but under the influence of certain reasons this does not always happen, these include injuries or features of the anatomical structure. If the eardrum has been damaged, then the liquid penetrates even into the middle ear;

• inflammatory processes. The feeling of squelching is the result of developing otitis media or inflammation of the Eustachian tube. Even fungal lesions can give this sensation. In most cases, congestion occurs due to the accumulation of pathological secretions behind the eardrum. The following signs may indicate inflammation: fever, pain and discharge from the ears, dizziness;

• sulfur plug.If the sensation of water in the ear is accompanied by congestion and a decrease in auditory function, then the presence of a sulfur plug can be suspected. Some may not even be aware of such a problem;

• increased sensitivity of the walls of the ear canal. Sometimes even using shampoo can provoke a reaction. As you know, irritated skin is vulnerable to attacks by pathogens.

What should not be done when you feel like water has entered your ear?

Let’s highlight four main mistakes that should in no case be allowed:

• use a hair dryer to dry your ear. So you will only burn yourself;

• try to get the sulfur plug with a cotton swab. Such a device sometimes leads to damage to the skin and threatens perforation of the eardrum;

• use beads for children;

• bury hot alcohol in the ear. It can also cause burns.

What to do if you feel water in your ear?

The following recommendations will help to get rid of the sensation in the ear:

• jump, while tilting your head to the side of the stuffy ear;

• move your lower jaw to the right and left sides;

• insert turunda dipped in boric alcohol;

• firmly press your palm to the auricle, and then abruptly remove.

Methods for removing sulfur plug

If the sulfur buildup is soft and light, you can try to fix it yourself. If the cork has a hard and dense consistency, then it is better to consult a specialist.

There are two ways to get rid of the sulfur plug:

1. Rinsing the ear canal.

2. Removal using special tools in the otolaryngologist’s office.

In any case, you should definitely consult your doctor. So, if the congestion was caused by an inflammatory process, then the washing procedure will only aggravate the situation.

The following medications will help dissolve the sulfur plug:

• Remo wax. The drug has a high safety performance. It is even approved for use by young children, because it does not contain aggressive components.Warm the product in your hand before use. The patient lies on his side so that the ear into which the drops will be instilled is on top. To straighten the ear canal, the auricle is pulled down and back. After use, you should lie down for ten minutes, and then repeat the procedure with the other ear. The ear canal should not be covered with cotton wool, otherwise the medicine may be absorbed;

• A-cerumen. The drug is used for both therapeutic and prophylactic purposes.With excessive production of sulfuric substance, A-cerumen prevents the formation of traffic jams. The agent is instilled twice a day for three days. The agent is in the ear canal for one minute, after which it is rinsed with saline.

So, the feeling that there is water in the ear can arise for various reasons. Sometimes the water after bathing just lingered in the ear, and in some cases, an unpleasant symptom is the result of an inflammatory process or the presence of a sulfur plug.Do not self-medicate, see a doctor, and be healthy!

This article is for informational purposes only, please consult your doctor for details!

90,000 Barotrauma of the ear upon impact on water

As they say, the sun, air and water are our best friends, but despite this popular opinion, swimmers and divers have a number of occupational diseases, in particular of the ears.
Dr. M. Wang and colleagues from the ENT department of Taipei Veterans Hospital, Taiwan, published a study on occupational ENT diseases in swimmers and divers. People who spend a lot of time in water or under water are characterized by acute diffuse external otitis media, otomycosis, exostosis, traumatic rupture of the tympanic membrane, middle ear infections, and barotrauma of the inner ear.
As a sport, kiteboarding is characterized by frequent falls and hits on the water, which can sometimes result in barotrauma.

The middle ear apparatus has dead spaces filled with air and connected to the outside world only through the Eustachian tubes that open into the nasopharynx.

Each of the two Eustachian tubes has a kind of one-way valve that opens into the nasopharynx. It has a protective function by blocking infection from entering the middle ear. Opening the tubes allows higher pressure air to flow from the throat to the middle ear. This is usually a conscious human action.Usually, simple swallowing gives this effect.
In fact, you unconsciously equalize the pressure in your ears many times a day. Oxygen is constantly absorbed by the tissues of the middle ear.

Thus, the air pressure in it decreases. When you swallow, the stretching muscles of the soft palate open the Eustachian tubes and open the way for air. When you do this, you hear a faint jolt or click.

Barotrauma. Injury to the middle ear as a result of sudden changes in atmospheric pressure.It occurs during an explosion, working in caissons, among pilots, divers, and upon impact on water. With an increase in atmospheric pressure, if it does not equalize in a timely manner in the middle ear through the auditory tube, the tympanic membrane retracts, with a decrease, it protrudes. Sudden changes in atmospheric pressure are transmitted through the eardrum and ossicular chain to the inner ear and negatively affect its function. Barotrauma may even be accompanied by a rupture of the eardrum.
The main cause of barotrauma is a rapid change in pressure and the inability of the middle ear to compensate for this change, which is facilitated by factors, the most important of which is a violation of the patency of the auditory tube.Edema of the mucous membrane and narrowing of the mouths of the Eustachian tubes are observed in inflammatory processes in the nasopharynx, and in cold water and in healthy individuals.

The middle ear is most sensitive to barotrauma, the lesion of which is in the nature of barotitis. Acute pain appears in the ear, frontal and maxillary (maxillary) sinuses, a feeling of congestion in the ears. There is a decrease in hearing, otoscopy reveals hyperemia of the tympanic membrane (Fig., A), and in some cases its rupture (Fig., B), which may be accompanied by bleeding from the ear.The wound surface in case of rupture of the tympanic membrane is treated with solutions of disinfectants; in the future (within 2-3 days), it is advisable to instill vasodilating drugs into the nose. Barootitis with rupture of the tympanic membrane can be complicated by acute purulent otitis media.

Symptoms, course. At the moment of barotrauma, a sharp “blow” to the ear and severe pain are felt. There is a decrease in hearing, sometimes dizziness, noise and ringing in the ears. With a ruptured eardrum – bleeding from the external auditory canal.
Treatment
If there is no rupture of the tympanic membrane, a sterile cotton ball is inserted into the ear canal. In case of rupture of the membrane, you should carefully blow in sulfa powder or antibiotics, apply a sterile dressing to the ear.
Drug therapy
– Drugs that reduce swelling of the mucous membrane of the nasal cavity
– Antihistamines
– Antibacterial drugs (in case of infection).
– Adrenomimetics are contraindicated in hypertension
If signs of ear barotrauma appear, consult a doctor.He will diagnose the damage and prescribe nasal drops that absorb tissue blocks in the Eustachian tubes, or antibiotics if there is a suspicion of nasopharyngeal infection. Special treatment for barotitis is not necessary – it is enough to wait until the health of the middle ear is restored, which usually takes from two days to two weeks. During this period, you must not dive and fly, otherwise repeated injury will occur. You should not cough and sneeze heavily at this time, and you should also not forcefully blow your nose.

After eardrum rupture, treatment can take up to three months, and in some cases even require surgery.

Can I continue to ride with barotrauma?
So, after skating, you came out with a pain in your ears. You have a feeling that your ears are filled with something (this is blood and mucus), and you cannot hear 100%. You have middle ear barotrauma.
However, overall, you are feeling well. The question is, can you continue to ride in this state? Some riders do this, but they are at great risk of losing their hearing completely or impairing the function of the vestibular system.
In addition, there is a real risk of infection. Remember that you cannot be sure that you may have injured your inner ear at the same time. The symptoms of inner ear barotrauma do not always appear immediately and are expressed quite clearly.
All medical advice says that if you have middle ear barotrauma, get out of the water and do not ride until a doctor’s examination.

How to protect yourself from barotrauma?
Of course, the use of a protective helmet with closed ears eliminates this problem.Starting to ride for the first time after an injury or if you have had ear pain before (i.e., the patency of the Eustachian corpses may be impaired due to the inflammatory process), or just riding in cold weather (cold water causes swelling of the mucous membrane), use earplugs. Closing the external auditory canal, they are rather securely fixed, taking the shape of the auditory canal. And protect against cold water and pressure drops when hitting water.
For the same purposes, a waterproof audio player is suitable, the headphones of which are made in the form of earplugs, and not only will allow you to listen to music, but also save your ears if you fall.

Sulfur plug can be a cause of hearing loss after falling into water.
Sulfur plug is a buildup of earwax in the ear canal. Normally, earwax serves as a natural lubricant for the walls of the external auditory canal. S. of the item is formed as a result of hypersecretion of the sulfur glands located in the external auditory canal and the increased viscosity of sulfur. The narrowness and tortuosity of the external auditory canal contribute to the accumulation of sulfur. At first it is soft, with time the S. of the item becomes dense and even stony; its color is light yellow or dark brown.Sometimes the plug consists mainly of a deflated epidermis – an epidermal plug.
If S. of the item does not completely close the lumen of the ear canal, it does not cause any disturbances. When the lumen is closed, a feeling of ear congestion and hearing loss, autophony (the resonance of one’s own voice in the superimposed ear) appear. These disorders develop suddenly, most often when water gets into the ear canal while bathing, washing the head (the sulfur plug swells at the same time) or when a match or hairpin is manipulated in the ear. If S. of the item presses on the walls of the ear canal and the eardrum, coughing, dizziness, noise in the ear, dysfunction of the sound-conducting apparatus occur. S.’s presence of the item is established on the basis of anamnesis, clinical picture and otoscopy data. Remove S. p. Rinsing the ear with warm water.

Sometimes it is preliminarily softened, for which 10 drops are instilled into the ear for 2-3 days, 3 times a day, an alkaline solution heated to 37 ° C (after instillation, it is necessary to lie down for 10-15 minutes).In this case, due to swelling of the plug, hearing may temporarily deteriorate.

2007 August © Copyright kite portal Kites.Ru Mikhail Soloveykin

Related articles:

90,000 What to do if a child has ear pain after swimming

Swimming is a useful sport that strengthens the muscle corset and hardens the body.

Therefore, parents often send their children to the pool. But sometimes the little swimmer complains that his ear hurts after the pool.What to do in such cases?

Causes of ear pain in a child

Contact with water is harmful to the ears – sulfur swells under the influence of a humid environment. Usually, in this case, the ear hurts from the fact that a plug has formed, and the inflammatory process begins. The main reasons for this are the residual fluid in the ear canal after diving, swimming and other water procedures.

After bathing

There may be water in the ear even after taking a bath or shower. Especially when the child’s hair is being washed, it is difficult to isolate the ear canals from the liquid.Therefore, immediately after bathing, you need to blot your ears with a towel, ask your child if he feels as if there is water in his ear.

After diving

When a child is about to dive into a pool or open water, you need to tell him about the precautions. After submerging in water, he subjects his ears to a serious test – there is a pressure drop. If, moreover, water gets into the ear, it can remain there and provoke an inflammatory process.

After the pool

While swimming in the pool, the child is in close contact with the water.Of course, it is poured into the ears, and it is necessary to remove it “on land”. It is not uncommon for children to have ear pain after the pool, because water droplets remain there, and when the child goes outside, he blows it. As a result, otitis media and other inflammatory diseases!

Symptoms of water entering the ear

If water has flowed into your ear, you should try to find it and remove it as soon as possible. The longer it stays inside, the more serious the consequences can be.

Otitis media or “water got into the ear”

In this case, the process develops rapidly – the child went outside after the pool with wet ear canals.Then he goes home, often in windy weather, plus on the way he can “grab” an infection. The very next day, the consequences are not long in coming:

• Feels pain in the ears
• Decreased hearing, often unilaterally
• The sound of water in the ear is felt, rolling
• The temperature rises, weakness and malaise appear

These conditions require immediate medical attention. Launched otitis media can harm the auditory system and even lead to more serious complications, such as inflammation of the meninges.

What is “swimmer’s ear”

In ENT practice, there is such a term as swimmer’s ear. It is associated with persistent irritation of the ear tract from chlorinated water. The disease manifests itself with the following symptoms:

• Redness of the outer ear
• Itching in the ear canal
• Persistent humid environment and swelling of wax in the ear

The process is aggravated by infection. Also, sometimes parents do the child a “disservice” by trying to clean the water and sulfur with cotton swabs.But instead of cleansing, they only remove the upper layer of the epithelium along with the protective microflora.

How to get rid of water in the ear

Parents of little swimmers are constantly concerned with the question of how to get rid of water in their ears. Some of them already have their own practiced techniques that make them great at home. But if the liquid has penetrated deeply, and a blockage has formed in the ear from water, you have to consult a doctor.

At home

The main thing to do is to wipe your ear after each visit to the pool.When picking up a child from the sports section, the parent must control this moment – take ordinary cotton pads with him and get the sink wet. It is also worth asking the child if he has a feeling that water has got into his ear and is standing in the depths of the passage. If so, you need to be more proactive.

To neutralize the effect of water, a turunda with boric alcohol or other drugs is placed in the ear canal. You need to hold it for 15-20 minutes, then remove it. If it does not help, you should contact an otolaryngologist.

Medication

It is worth contacting an ENT when it was not possible to clean your ears at home or if your ear hurts after the pool. The doctor will conduct an examination and prescribe the necessary measures. Often, the problem is solved by flushing with Janet’s syringe. This may sound strange – how does water help remove water? But the fact is that in these cases, if the ear hurts and lays down, it is not from the water itself, but from the swelling of sulfur inside it. Rinsing helps to clean everything thoroughly.

In some cases, the doctor prescribes drops and other medications. If an inflammatory process has formed, prescribes the treatment of otitis media: antibiotics, anti-inflammatory drugs, physiotherapy procedures.

How do I keep water out of my ears? Prevention

Parents of little swimmers often ask what to do if their ear hurts after swimming. However, the most correct answer is to avoid such situations at all. If you carefully monitor the hygiene of your child’s ears and dry them after swimming, there will be no problem.There are also additional means of protection – for example, earplugs.

Swimming earplugs

Special earplugs for swimming reliably protect the ear canal from water and pressure drops.