Thanks for posting this! I am looking for exactly the expertise in diving medicine that you possess and have not been able to find this in the health care I have access to. Therefore I would greatly appreciate if you could help me with the question below! I have been diagnosed with inner ear barotrauma on my right ear as a result of two incidents while freediving. September 2022: A minor injury (right ear) with only a slight permanent hearing loss, fullness, but no dizziness or nausea. August 2023: A more serious injury (right ear) with a short-term total hearing loss, nausea, dizziness and tinitus for a period of 2-3 weeks and then a permanent hearing loss (let's say 40%) as the only long term consequense. My theory is that the barotrauma of the inner ear is caused by excessive equlization (valsalva) due to blocked eustachian tubes (due to disease in the first incident and fatigue in the second). I simply cannot imagine a life without diving. My plan is therefore to resume diving after 2-3 years, when the injury hopefully has healed, but only after I have learned the gentler equalization technique (Frenzel). The idea here is that Frenzel is too soft a technique to provoke another barotrauma in the inner ear. How does that approach sound to you? What would you recommend when it comes to getting back into diving? Really hope to hear from you. Thanks!
Please respond how to treat a minor barotrauma from scuba diving? My doctor gave me ear drops but i feel like that's not necessary at all. He looked into ny ears and they were fine
Work at a truck stop and a few years ago I was suckered punched twice while I was looking away with my mouth open talking my jaw hasn't Closedd right in a while its crooked, and well I have been stressed and clinching my jaw alot and then one of the guy driving there freaking trucks did there air pressure release on there truck while I was right in-between them and another truck and immediately I felt a sharp pain and i felt a pressure like my ear was half popped and I've had it for over a week
@@DANSouthernAfrica hello, 4 years ago I had bacterial sinusitis from an Oro-Antral fistula after tooth #2 was extracted. The infection spread to both ears (I lost 95 percent of my hearing in one ear for a few hours and then I had pain in both eats with popping and crackling). I got tinnitus from this and in a desperate attempt to resolve my tinnitus I did the Valsalva maneuver a few times. While doing the valsalva maneuver I would: pinch my nose and close my mouth and slow to moderately blow out my nose to open my eustachian tubes. I would hear one open then I would continue to to do the valsalva maneuver until I heard the 2nd ear pop... then I would keep blowing a little longer then I would hear a weird noise from either my tympanic membrane expanding like a sail on a sailboat, my ossicular chain moving or both. I have normal audiograms but I have permanent bilateral high pitched tinnitus and my voice permanently and subjectively sounds like a broken speaker. What kind of damage could I have done to my inner ear? I never had vertigo. I eventually saw a few Nuerotologists to rule out Lateral/horizontal Semicircular Canal Dehiscence Syndrome (at John's Hopkins here in the states). Again , could I have caused permanent damage from doing the valsalva when I never ruptured my Tympanic membrane or my round or oval windows? I was 43 when this happened. Perfect hearing before the infection. My voice subjectively has sounded distorted eversince all those events occured 4 years ago. My voice sounds 85 percent normal with intermittent cacophony that shadows my voice and that occasionally gives me the nails-on-a-chalkboard like sensation. My recorded voice sounds normal to me (my normal recorded voice). My voice sounds the same to everyone but myself. I don't know if the damage in my maxillary sinus cavity could still be causing this OR if there is permanent damage to my inner ear? I have normal vemp tests, normal ABR, normal audiograms, normal CT scans and a normal MRI. I have been depressed and in severe distress over this everyday since this happened. What is your opinion what happened? Thanks
I had a slight pressure on decent. Paused and went up for a bit. Eventually got to the bottom of about 25ft deep. Immediately after the dive I have felt pressure like my ears are still under water. It went away after a day or so. Then I flew back to work, now it's back. It's been a few hours. My dad was scuba certified for many years when my younger brothers continued into scouts. He stopped diving due to ear problems after diving. I'm thinking there's a hereditary ear issue, I want a solution so I can continue diving.
Thanks for the question. Short lasting fullness in the ear is rarely inner ear related. Does the fullness subside if you equalise the ears? If so, then it is probably related to mild pressure imbalance due to your Eustachean tube being a bit swollen. Unless you have deafness, tinnitus or vertigo, it is very unlikely to be your inner ear. You may want to watch our video on equalising techniques or try an Otovent or Boots Sinus rinse. If these do not solve your problems, it would be wise to see a Diving Physician or ENT. My sense is you are going to be OK. Take care. Dr Frans Cronje
Hey there just watched your video on ear trauma after diving, Today I was diving in roughly 4m of water had already been free diving for a couple of hours in varying depths mabe 10m up was quite tired and may have pushed the limits I now know I need to stop next time I cant equalise anyway I have always had trouble equalising. I was on the desent pinched my nose to equalise got left ear to equalise but not my left went down about another meter then ruptured my right ear tried to equalise again after incident could hear air pushing threw drum very painful im thinking now that ive ruptured it a number of times that there may be other issues causing me to not be able to equalise possibly scar tissue? do you have any tips or suggestions also how long do these type of ruptures take to heal thank you in advance.
Thank you for your questions. First of all, I think that you need to see an ENT -- preferably one with diving expertise, although this is not essential. They need to see if there is scar tissue on the eardrum or unusual thinness that makes it rupture more easily. I suspect there is a difference in compliance between your two eardrums -- in other words, the one has a 'looser' ear drum membrane that can tolerate a larger pressure-volume change before it causes pain than the other one does. This is quite common and divers often think this means that the one ear is struggling to equalise. Actually, this is not always the case -- the one just senses pressure faster than the other. Tympanometry can identify this type of problem and is a routine test that ENTs perform. Rather than speculating on all the possibilities, could we start with this and see if we can get you to see a suitable ENT. If you can send us your area of residence, we might be able to find the closest diving ENT near you. Hope this sheds some light on your difficulty. Thank you for caring enough to take the trouble to write to us. We really want to make sure you get the best possible care and find an appropriate solution. Kind regards, Dr. Frans Cronje
@@DrFJCronje okay that makes of sense thank you for a informative reply there are ENTS in my area none I know of with dive experience im based in marlbourgh New Zealand.
Interesting question. Inner Ear Barotrauma almost never occurs without concurrent straining maneuvers to equalize (i.e., forced prolonged Valsava maneuvers). Even elevator descents from the tallest skyscrapers in the world are unlikely to require such strainful efforts. One scenario in which inner ear barotrauma may occur is if there is a sudden rise in intracranial pressure after there has been a mild prior episode of inner ear barotrauma. For instance: We had this happen to a fireman. He had struggled to equalize the ear during a dive, and the next day, after carrying and nearly tripping with a patient on a stretcher, he developed sudden vertigo and deafness. This delayed form of inner ear barotrauma is rare, but it can occur. I am not sure if I have addressed your answer satisfactorily, so please refine your question if you need more information. All the best, Dr Frans Cronje
@DrFJCronje hello Dr Frans, 4 years ago I had bacterial sinusitis from an Oro-Antral fistula after tooth #2 was extracted. The infection spread to both ears (I lost 95 percent of my hearing in one ear for a few hours and then I had pain in both eats with popping and crackling). I got tinnitus from this and in a desperate attempt to resolve my tinnitus I did the Valsalva maneuver a few times. While doing the valsalva maneuver I would: pinch my nose and close my mouth and slow to moderately blow out my nose to open my eustachian tubes. I would hear one open then I would continue to to do the valsalva maneuver until I heard the 2nd ear pop... then I would keep blowing a little longer then I would hear a weird noise from either my tympanic membrane expanding like a sail on a sailboat, my ossicular chain moving or both. I have normal audiograms but I have permanent bilateral high pitched tinnitus and my voice permanently and subjectively sounds like a broken speaker. What kind of damage could I have done to my inner ear? I never had vertigo. I eventually saw a few Nuerotologists to rule out Lateral/horizontal Semicircular Canal Dehiscence Syndrome (at John's Hopkins here in the states). Again , could I have caused permanent damage from doing the valsalva when I never ruptured my Tympanic membrane or my round or oval windows? I was 43 when this happened. Perfect hearing before the infection. My voice subjectively has sounded distorted eversince all those events occured 4 years ago. My voice sounds 85 percent normal with intermittent cacophony that shadows my voice and that occasionally gives me the nails-on-a-chalkboard like sensation. My recorded voice sounds normal to me (my normal recorded voice). My voice sounds the same to everyone but myself. I don't know if the damage in my maxillary sinus cavity could still be causing this OR if there is permanent damage to my inner ear? I have normal vemp tests, normal ABR, normal audiograms, normal CT scans and a normal MRI. I have been depressed and in severe distress over this everyday since this happened. What is your opinion what happened? Thanks
@@baseballlive77 Thank you for sharing your detailed history and experiences regarding your sinusitis and its aftermath. It’s understandable that this situation has caused you significant distress, and I appreciate the opportunity to address your concerns. From what you describe, it seems that you have undergone extensive evaluations, including audiograms, VEMP tests, ABR, CT scans, and an MRI, all of which returned normal results. This is reassuring in some respects, as it suggests that there may not be obvious structural damage to your inner ear or surrounding structures. However, the persistence of your tinnitus and the altered perception of your voice indicate that there may still be underlying issues to consider. The Valsalva maneuver, while often used to equalize pressure in the ears, can potentially lead to complications if performed improperly or excessively, especially in the context of existing ear conditions. While you did not rupture your tympanic membrane or windows, the repeated pressure changes could have impacted the delicate structures of the inner ear or exacerbated any existing conditions, such as Eustachian tube dysfunction. It’s also important to acknowledge that tinnitus can arise from various sources, including changes in auditory processing or issues within the auditory pathway that may not be easily detected on standard testing. Your description of your voice sounding distorted to yourself, while recorded versions sound normal, suggests a potential auditory processing issue or even a somatosensory contribution to your perception. Given your situation, I recommend continuing to work closely with your healthcare team, particularly an ear, nose, and throat (ENT) specialist who can help explore both auditory and non-auditory factors contributing to your symptoms. Cognitive behavioral therapy, neurofeedback, tinnitus retraining therapy, or sound therapy may also offer relief for the distress caused by your tinnitus. It’s crucial to be gentle with yourself during this time, as the psychological impact of your ordeal and ongoing frustration is not trivial; rather, it can be profound. Seeking support from mental health professionals or support groups may also help you navigate the emotional aspects of your experience.
In conclusion, while it’s difficult to ascertain the exact nature of any potential damage without more invasive tests, your proactive approach to your health is commendable. Continue advocating for yourself and seeking answers, and please don’t hesitate to reach out for additional support as needed. Wishing you strength and clarity on your journey toward understanding and healing. Best regards.Dr Frans Cronje
I always have a medium dizziness lasting 24 hours after every dive. It is annoying and ruins this otherwise great recreational activity for me. I was diagnosed with a small left right shunt in the heart. Is it possible that this causes frequent IEDCS even when following the dive tables?
Who else sitting here with a ringing sound in ear
I sure am. The weird part is I was freediving at 15 to 20 ft water
I was at 5 feet
Thanks for posting this! I am looking for exactly the expertise in diving medicine that you possess and have not been able to find this in the health care I have access to. Therefore I would greatly appreciate if you could help me with the question below!
I have been diagnosed with inner ear barotrauma on my right ear as a result of two incidents while freediving. September 2022: A minor injury (right ear) with only a slight permanent hearing loss, fullness, but no dizziness or nausea. August 2023: A more serious injury (right ear) with a short-term total hearing loss, nausea, dizziness and tinitus for a period of 2-3 weeks and then a permanent hearing loss (let's say 40%) as the only long term consequense.
My theory is that the barotrauma of the inner ear is caused by excessive equlization (valsalva) due to blocked eustachian tubes (due to disease in the first incident and fatigue in the second). I simply cannot imagine a life without diving. My plan is therefore to resume diving after 2-3 years, when the injury hopefully has healed, but only after I have learned the gentler equalization technique (Frenzel). The idea here is that Frenzel is too soft a technique to provoke another barotrauma in the inner ear. How does that approach sound to you? What would you recommend when it comes to getting back into diving?
Really hope to hear from you. Thanks!
Please respond how to treat a minor barotrauma from scuba diving? My doctor gave me ear drops but i feel like that's not necessary at all. He looked into ny ears and they were fine
Work at a truck stop and a few years ago I was suckered punched twice while I was looking away with my mouth open talking my jaw hasn't Closedd right in a while its crooked, and well I have been stressed and clinching my jaw alot and then one of the guy driving there freaking trucks did there air pressure release on there truck while I was right in-between them and another truck and immediately I felt a sharp pain and i felt a pressure like my ear was half popped and I've had it for over a week
Thank you for sharing.
@@DANSouthernAfrica hello, 4 years ago I had bacterial sinusitis from an Oro-Antral fistula after tooth #2 was extracted. The infection spread to both ears (I lost 95 percent of my hearing in one ear for a few hours and then I had pain in both eats with popping and crackling). I got tinnitus from this and in a desperate attempt to resolve my tinnitus I did the Valsalva maneuver a few times. While doing the valsalva maneuver I would: pinch my nose and close my mouth and slow to moderately blow out my nose to open my eustachian tubes. I would hear one open then I would continue to to do the valsalva maneuver until I heard the 2nd ear pop... then I would keep blowing a little longer then I would hear a weird noise from either my tympanic membrane expanding like a sail on a sailboat, my ossicular chain moving or both.
I have normal audiograms but I have permanent bilateral high pitched tinnitus and my voice permanently and subjectively sounds like a broken speaker. What kind of damage could I have done to my inner ear? I never had vertigo. I eventually saw a few Nuerotologists to rule out Lateral/horizontal Semicircular Canal Dehiscence Syndrome (at John's Hopkins here in the states).
Again , could I have caused permanent damage from doing the valsalva when I never ruptured my Tympanic membrane or my round or oval windows?
I was 43 when this happened. Perfect hearing before the infection.
My voice subjectively has sounded distorted eversince all those events occured 4 years ago. My voice sounds 85 percent normal with intermittent cacophony that shadows my voice and that occasionally gives me the nails-on-a-chalkboard like sensation.
My recorded voice sounds normal to me (my normal recorded voice). My voice sounds the same to everyone but myself.
I don't know if the damage in my maxillary sinus cavity could still be causing this OR if there is permanent damage to my inner ear?
I have normal vemp tests, normal ABR, normal audiograms, normal CT scans and a normal MRI.
I have been depressed and in severe distress over this everyday since this happened.
What is your opinion what happened?
Thanks
I had a slight pressure on decent. Paused and went up for a bit. Eventually got to the bottom of about 25ft deep. Immediately after the dive I have felt pressure like my ears are still under water. It went away after a day or so. Then I flew back to work, now it's back. It's been a few hours. My dad was scuba certified for many years when my younger brothers continued into scouts. He stopped diving due to ear problems after diving. I'm thinking there's a hereditary ear issue, I want a solution so I can continue diving.
Thanks for the question. Short lasting fullness in the ear is rarely inner ear related. Does the fullness subside if you equalise the ears? If so, then it is probably related to mild pressure imbalance due to your Eustachean tube being a bit swollen. Unless you have deafness, tinnitus or vertigo, it is very unlikely to be your inner ear. You may want to watch our video on equalising techniques or try an Otovent or Boots Sinus rinse. If these do not solve your problems, it would be wise to see a Diving Physician or ENT. My sense is you are going to be OK. Take care. Dr Frans Cronje
@@KHAMH-Baromedicine Thank you for responding.
Hey there just watched your video on ear trauma after diving,
Today I was diving in roughly 4m of water had already been free diving for a couple of hours in varying depths mabe 10m up was quite tired and may have pushed the limits I now know I need to stop next time I cant equalise anyway I have always had trouble equalising.
I was on the desent pinched my nose to equalise got left ear to equalise but not my left went down about another meter then ruptured my right ear tried to equalise again after incident could hear air pushing threw drum very painful im thinking now that ive ruptured it a number of times that there may be other issues causing me to not be able to equalise possibly scar tissue? do you have any tips or suggestions also how long do these type of ruptures take to heal thank you in advance.
Thank you for your questions. First of all, I think that you need to see an ENT -- preferably one with diving expertise, although this is not essential. They need to see if there is scar tissue on the eardrum or unusual thinness that makes it rupture more easily. I suspect there is a difference in compliance between your two eardrums -- in other words, the one has a 'looser' ear drum membrane that can tolerate a larger pressure-volume change before it causes pain than the other one does. This is quite common and divers often think this means that the one ear is struggling to equalise. Actually, this is not always the case -- the one just senses pressure faster than the other. Tympanometry can identify this type of problem and is a routine test that ENTs perform. Rather than speculating on all the possibilities, could we start with this and see if we can get you to see a suitable ENT. If you can send us your area of residence, we might be able to find the closest diving ENT near you. Hope this sheds some light on your difficulty. Thank you for caring enough to take the trouble to write to us. We really want to make sure you get the best possible care and find an appropriate solution. Kind regards, Dr. Frans Cronje
@@DrFJCronje okay that makes of sense thank you for a informative reply there are ENTS in my area none I know of with dive experience im based in marlbourgh New Zealand.
Can Barotrauma comming from Elevator ( lift )?!
Interesting question. Inner Ear Barotrauma almost never occurs without concurrent straining maneuvers to equalize (i.e., forced prolonged Valsava maneuvers). Even elevator descents from the tallest skyscrapers in the world are unlikely to require such strainful efforts. One scenario in which inner ear barotrauma may occur is if there is a sudden rise in intracranial pressure after there has been a mild prior episode of inner ear barotrauma. For instance: We had this happen to a fireman. He had struggled to equalize the ear during a dive, and the next day, after carrying and nearly tripping with a patient on a stretcher, he developed sudden vertigo and deafness. This delayed form of inner ear barotrauma is rare, but it can occur. I am not sure if I have addressed your answer satisfactorily, so please refine your question if you need more information. All the best, Dr Frans Cronje
@DrFJCronje hello Dr Frans, 4 years ago I had bacterial sinusitis from an Oro-Antral fistula after tooth #2 was extracted. The infection spread to both ears (I lost 95 percent of my hearing in one ear for a few hours and then I had pain in both eats with popping and crackling). I got tinnitus from this and in a desperate attempt to resolve my tinnitus I did the Valsalva maneuver a few times. While doing the valsalva maneuver I would: pinch my nose and close my mouth and slow to moderately blow out my nose to open my eustachian tubes. I would hear one open then I would continue to to do the valsalva maneuver until I heard the 2nd ear pop... then I would keep blowing a little longer then I would hear a weird noise from either my tympanic membrane expanding like a sail on a sailboat, my ossicular chain moving or both.
I have normal audiograms but I have permanent bilateral high pitched tinnitus and my voice permanently and subjectively sounds like a broken speaker. What kind of damage could I have done to my inner ear? I never had vertigo. I eventually saw a few Nuerotologists to rule out Lateral/horizontal Semicircular Canal Dehiscence Syndrome (at John's Hopkins here in the states).
Again , could I have caused permanent damage from doing the valsalva when I never ruptured my Tympanic membrane or my round or oval windows?
I was 43 when this happened. Perfect hearing before the infection.
My voice subjectively has sounded distorted eversince all those events occured 4 years ago. My voice sounds 85 percent normal with intermittent cacophony that shadows my voice and that occasionally gives me the nails-on-a-chalkboard like sensation.
My recorded voice sounds normal to me (my normal recorded voice). My voice sounds the same to everyone but myself.
I don't know if the damage in my maxillary sinus cavity could still be causing this OR if there is permanent damage to my inner ear?
I have normal vemp tests, normal ABR, normal audiograms, normal CT scans and a normal MRI.
I have been depressed and in severe distress over this everyday since this happened.
What is your opinion what happened?
Thanks
@@baseballlive77 Thank you for sharing your detailed history and experiences regarding your sinusitis and its aftermath. It’s understandable that this situation has caused you significant distress, and I appreciate the opportunity to address your concerns.
From what you describe, it seems that you have undergone extensive evaluations, including audiograms, VEMP tests, ABR, CT scans, and an MRI, all of which returned normal results. This is reassuring in some respects, as it suggests that there may not be obvious structural damage to your inner ear or surrounding structures. However, the persistence of your tinnitus and the altered perception of your voice indicate that there may still be underlying issues to consider.
The Valsalva maneuver, while often used to equalize pressure in the ears, can potentially lead to complications if performed improperly or excessively, especially in the context of existing ear conditions. While you did not rupture your tympanic membrane or windows, the repeated pressure changes could have impacted the delicate structures of the inner ear or exacerbated any existing conditions, such as Eustachian tube dysfunction.
It’s also important to acknowledge that tinnitus can arise from various sources, including changes in auditory processing or issues within the auditory pathway that may not be easily detected on standard testing. Your description of your voice sounding distorted to yourself, while recorded versions sound normal, suggests a potential auditory processing issue or even a somatosensory contribution to your perception.
Given your situation, I recommend continuing to work closely with your healthcare team, particularly an ear, nose, and throat (ENT) specialist who can help explore both auditory and non-auditory factors contributing to your symptoms. Cognitive behavioral therapy, neurofeedback, tinnitus retraining therapy, or sound therapy may also offer relief for the distress caused by your tinnitus.
It’s crucial to be gentle with yourself during this time, as the psychological impact of your ordeal and ongoing frustration is not trivial; rather, it can be profound. Seeking support from mental health professionals or support groups may also help you navigate the emotional aspects of your experience.
In conclusion, while it’s difficult to ascertain the exact nature of any potential damage without more invasive tests, your proactive approach to your health is commendable. Continue advocating for yourself and seeking answers, and please don’t hesitate to reach out for additional support as needed.
Wishing you strength and clarity on your journey toward understanding and healing.
Best regards.Dr Frans Cronje
I always have a medium dizziness lasting 24 hours after every dive.
It is annoying and ruins this otherwise great recreational activity for me.
I was diagnosed with a small left right shunt in the heart.
Is it possible that this causes frequent IEDCS even when following the dive tables?
It will be best to reach out to the DAN medical team via email at danmedic@dansa.org or via the DAN Information Hotline on +27-82-810-6010