The impact of regular diving on the condition of the middle ear

Abstract

It is generally held that exposure to both high-pressure and long-lasting contact with water makes diving a potentially hazardous sports activity as far as the ears are concerned. There is a number of research investigating the condition of the middle ear in a short period following diving; however, the knowledge regarding the long-term effects of regularly repeated diving remains limited. Material and Methods: The aim of this study is to evaluate the function of the middle ear after a diving season in a group of 31 adults diving regularly (1-17 years) by means of the following methods: 1) interview, 2) otoscopy, 3) pure tone audiometry, 4) classic tympanometry, and 5) wideband tympanometry. Results: Periodic problems with pressure equalization in the middle ear were observed in 12 individuals (38.7%). In all the analyzed cases, the authors found a normal condition of the external auditory canal and the tympanic membrane in otoscopy, normal hearing in pure tone audiometry, curve type A, and normal gradient in both classic and wideband tympanometry. Conclusions: Safe diving (according to safety precautions) does not have any long-term negative effects on the condition of the middle ear. However, these observations should be verified in a larger group of divers. Int J Occup Med Environ Health. 2021;34(6)

Barotrauma of the ear and paranasal sinuses

“…4 Factors that potentiate the closure of the tube may be congenital, anatomical, or acquired such as inflammatory edema, vegetation, or tumors. 5 The next important factor in the flow of air and pressure through the middle ear is the mastoid. The volume of the middle ear is about 2 cm 3 , and the size of the mastoid is on average 12 cm 2 , with variations from 3 to 25 cm 2 .…”

“…It is important to emphasize that the ear inserts in the external auditory canal prevent the barotrauma of the middle ear, but not of the outer ear, therefore they are acceptable for shallow water immersions. 5,9 Individuals who had undergone stapedectomy or ossicular reconstructions do not have an increased risk of damage to the inner ear when diving, to the extent it has been understood so far, but they dive at their own risk. It is necessary to assess whether sudden changes in body position represent a risk for newly established architectonics of ossicles and implants, and the risk of a liquor fistula in the stapes area is extremely difficult to assess.…”