Diving is a popular sport, but those who participate professionally or as amateurs must be aware of the dangers.
Freediving or scuba diving even at seemingly innocent depths puts significant stress of the cardiovascular system, the ears and the lungs.
Unexpected incidents during diving, like reduced resistance and pre-existing illnesses increase the risk of an accident.
An international study revealed that small accidents happen in 1,3% of all diving activities and decompression accidents in 2 out of 10.000 dives
Medical evaluation is required in order to find out if one is suitable for diving.
Ear and sinuses problems when diving
A basic diving rule is pressure equalization between nose and ears. The divers carry out these equalizations (Valsava maneuver) every 1 ½ to 2 meters of diving.
Barotrauma is the tissue injury which occurs during diving or emerging.
With the increased diving pressure, the air volume in air-filled cavities like the lungs, the middle ear (behind the drum), the sinus cavities and the digestive tract is reduced.
If the pressure in these cavities is not equalized with the external pressure, then we have tissue injuries due to the pressure difference.
Middle-ear barotrauma
It happens when pressure in the middle ear is not equalized to the outside pressure, especially when there are anatomical obstacles (tilted septum, polyps), local edema from allergies or respiratory system infection, as all of the above obstruct the function of the eustachian tube.
While the pressure in the middle ear becomes increasingly negative as the depth increases, the tympanic membrane moves inwards causing ear pain and may ultimately rupture. Then the cold water will enter the middle ear, unilaterally irritating the labyrinth and causing acute vertigo.
Inner-ear barotrauma
Inner-ear barotrauma happens during diving when the diver cannot equalize the pressures on the middle ear, despite repeated and violent Valsava maneuvers.
Because with Valsava pressures the pressure in the spinal fluids increases and therefore in fluids in the fluids in the cochlea (inner ear). In this way the windows of the cochlea may break and lymph fluids may leak.
The diver feels a sudden vertigo, tinnitus and hear loss in the affected ear. The treatment may require surgical restoration of the wounded windows in order to restore hearing. If it is not treated conservatively or surgically, then the damage leading to hearing loss and tinnitus may remain for ever.
When the diver experiences barotrauma symptoms he must be immediately examined by a specialized ENT surgeon and not try to conduct more Valsava maneuvers, although he feels his ear blocked.
