Ear nose throat specialist clinic

April 3, 2009

Dangers in Diving with Ear Problem

Absolute Contraindications
Inability to equalize pressure in the middle ear by auto-inflation. This may be due to a correctable problem such as polyps, nasal septal deviation or coryza in which case the diver can be reevaluated after correction of the problem.
Perforation of the tympanic membrane. Until fully healed or successfully repaired with good Eustachian tube function, diving is contraindicated.
Open, nonhealed perforation of the TM.
Monomeric TM
Tympanoplasty, other than myringoplasty (Type I)
History of stapedectomy. * Recent studies have shown that this is not necessarily true. See this article:
Otolaryngol Head Neck Surg 2001 Oct;125(4):356-60
Diving after stapedectomy: clinical experience and recommendations.
House JW, Toh EH, Perez A.
Clinical Studies Department, House Ear Clinic and Institute, 2100 West Third
Street, Los Angeles, CA 90057, USA.

CONCLUSIONS: Stapedectomy does not appear to increase the risk of inner ear
barotrauma in scuba and sky divers. These activities may be pursued with
relative safety after stapes surgery, provided adequate eustachian tube
function has been established.

History of inner ear surgery
Status post laryngectomy or partial laryngectomy
History of vestibular decompression sickness
Radical mastoidectomy (posterior) involving the external canal is disqualifying. (Closed childhood OK)
Meniere’s disease is disqualifying
Labyrinthitis
Perilymphatic fistula
Cholesteatoma is disqualifying
Cerumen impactions -remove before allowing to dive.
Stenosis or atresia of the ear canal-disqualifying.
Facial paralysis secondary to barotrauma
Tracheostomy, tracheostoma
Incompetent larynx due to surgery (Cannot close for valsalva maneuver)
Laryngocoele

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