equalization -what happened?

[XabreTooth]

Hi

I went swimming in the habour three days ago - no gear, no mask. I did a couple of dives to the botton.

As I hit the bottom at some 10-12m, suddenly I heard this 'pfffffft'-sound in my left ear. I thought: was that my eardrum which just blew? I was puzzled since I felt my equalization was good, and I had felt no discomfort on the way down.

I turned emmidiately and at the same time a strong vertigo hit me. I was having trouble swimming straight up, and back at the surface everything was rotating. During the next 5-10 minutes the vertigo gradually faded.

The day after I visited an ear-specialist - who told me nothing was wrong with my ear! He offered me no alternative explanation as to what had happened.


- Any help understanding what happened will be greatly appreciated.

 

[Kars]

Initially is sounded like ear drum rupture, but than you went to the doc and did not see anything, I think it had to come from within.

Let's explore the possibilities.

You dove down without any gear, wearing no fins I presume.
- Did you swim down with whilst not keeping your nose closed?
- Did you consciously equalise on the way down?
- How did you equalise? (valsava, frenzel, BTV, .. ?)
- When surfacing did fluid exit your sinuses and or Eustachian tubes?
- Describe your normal mask clearing routine(s)
- Did you experience any reverse block symptoms?
- Could you equalise easy before and after the incident?
- Did you suffer from any excess mucus or sinus fluids?

As for now I think that while diving some water or sinus fluid got into Eustachian left ear tube and trapped some air. When turning around or some other (internal) movement lead to shifting some trapped air or fluid to stir you inner ear.

I hope more knowledgeable people like to chime in too.

Love, Courage and Water,

Kars

 

[Bill]

I know very little about the ear and don't even have a clear picture of the parts. Over the years divers (probably repeating what doctors told them) referred to inner ear, outer ear and middle ear. I think the outer ear is the part that is open to the air or water and the inner ear must be cleared through the eustachian tube that we're all familiar with but there is more to it than that. There is something called a round window that can rupture. If I remember right it is usually done with a reverse squeeze. In my case, I did something by creating too much pressure with my tongue trying to equalize a sinus. Bad idea.

Oops, my cut and paste skills leave a little to be desired. Having said all that, the most probable cause that I can think of is a sinus equalizing.

 

[Kars]

Bill in case of a Sinus equalising I would not expect the vertigo experienced by Xabretooth.
The balance sensing happens in the inner ear.

Kars

 

[cp1204]

I had same symptoms a week ago. Strange sound when equalizing, like if water suddenly went deeper into ear. Then disorientation for maybe 10 seconds. I have read somewhere, that cold water in inner ear causes temporary disfunction of vestibular apparatus (I'm not shure what correct term is). For a day after that happened I had ear pains, and until now my ear feels strange. I have seen two doctors, passed two antibiotics courses, used different prescripted ear drops, but my ear still feels strange.

 

[Kars]

I've heard of the cold water causing vertigo.

I would suggest to clean up your sinus and tubes, have plenty of sleep and water and avoid any mucus (slime) inducing food.

Kars

 

[Rik]

The ear is devided in three parts:
1. the outer ear, existing of the outer ear canal and the external side of the eardrum.
2. the middle ear, existing of the the inner part of the eardrum, the three ear bones, the entry to the mastoid bone, the exit through the eustachian tube, the facialis nerve, and the round and oval window. The three ear bones are connecting the eardrum with the oval window.
3. The inner ear. The inner ear two organs. One organ, directly behind the oval window, translates the sounds waves into nerve signals. The second organ exists of tubes, which translate motion of the head into nerve signals.

In diving, vertigo can be caused by sudden cold water entering the middle ear. It can also be caused by a rupture of the oval or round window.

If an accident occurs with sudden hearing loss and vertigo, I would refer any of my students to an ENT physican with diving knowledge. If there is no ENT physican around with this knowledge, I would advice them to seek advice with a diving physican.

 

[vali]

this was happened to me in scuba
i could'nt equalize at 3 m under surface...there was no pain in my left ear, but i felt like the ear was obtured somehow
immediately after i manage to equalize i had this 5 seconds of vertigo and after this the ear was easy to equalize...

 

[cp1204]

I'm going to hospital for three weeks Diagnosis is sensorineural hearing loss.

 

[EcchiK]

Good luck on the recup. and whatever the hospital visit will bring. Hope you get well!

 

[cp1204]

Thank you!

 

[XabreTooth]

- thanks for your replies everybody!

Thou I have not come to a conclusion, your post have offered me some help with reflecting on what happened.

It appears to me, that the sudden pressure change, I experienced, must have happened on the inside of the ear drum. A excess pressue must have been built up in a section of the eustachian tube, which suddenly released towards the only partially equalized let ear.

The sudden pressure change on the ear drum caused the vertigo, with perhaps the rather cold water at depth (probably around 13-14 C) playing its part, too.

 

[calliecal]

I often get this on SCUBA (though thank goodness not whilst spearing yet), it's called alternobaric vertigo. It happens when one ear equalizes and the other doesn't which gives the body the sensation of spinning.

Sometimes there is barotrauma associated but most often there isn't, for me anyway - so nothing's ruptured or anything - but you can hear the air exit one eustachian tube which was that strange 'pffft' noise you heard at the bottom. It's more pronounced in the vertical position which is why you felt it most strongly when you turned to go up. Often the vertigo clears itself on the way up (on SCUBA anyway.. where you have a lot more time to get to the surface) but it essentially goes away when the pressure in both ears are the same again.

 

[XabreTooth]

- thanks a lot! That makes much sense.

 

[calliecal]

No problem