Q: I came up from a dive, and now my ears feel full, my hearing is muffled, and I have ear pain. What should I do?
A: The symptoms you mention typically indicate a middle-ear barotrauma, which usually results from inadequate pressure equilibration between the middle ear and the external ambient pressure. The typical symptoms are a sensation of ear blockage or fullness, some hearing loss, effusion (fluid build-up) in the middle ear, and pain. Other symptoms may include mild tinnitus, vertigo, or dizziness.
Severe vertigo, tinnitus, and pain suggest possible involvement of the inner ear, which can be very serious. Multiple consecutive days of diving may result in mild congestion, leading to impaired Eustachian tube function, which can present a greater risk of middle-ear barotrauma.
If you experience symptoms following a dive, DAN recommends immediately discontinuing diving and seeking an immediate medical evaluation. Attempting to equalise again will likely exacerbate the injury, extend your healing time, or lead to a more serious inner-ear injury. Your physician may prescribe antibiotics or steroids, and they may direct you to use a decongestant and anti-inflammatory medication to help reduce symptoms.
Unfortunately, nothing can get you back in the water right away. Only time can resolve this injury, which can take up to four to six weeks, depending on the injury’s severity. Returning to diving too soon could put you at risk for more severe barotrauma, which can result in permanent hearing loss, vestibular and balance issues, infection, or other complications.
If middle-ear barotrauma was the extent of your injury, returning to diving should not present a problem once a physician has verified that the condition has completely healed. A physician should verify that you have no vestibular dysfunction, fluid in the ears, pain, muffled hearing, and clicks or Rice Krispies sounds in your ear.
Burst / perforated eardrums
Q: Do burst or perforated eardrums heal?
A: Yes. Burst eardrums usually heal within a few weeks although in severe cases surgery could be required to repair a badly damaged eardrum. The diver should have the ear checked by a doctor before returning to diving.
Caring for a diver with DCI
Q: Should you keep a diver suffering DCI warm or cold?
A: A diver suffering from DCI should be kept at a comfortable temperature. Divers should avoid having hot showers soon after diving as the heat can cause nitrogen to be eliminated more rapidly and occasionally can precipitate DCI. The studies dealing with survival in cold temperatures are unrelated to DCI management.
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