Last update:  10/5/14 

Scuba    diving    refers    to    the    form    of    underwater    diving    in    which    a    diver    uses    a    Self-Contained    Underwater    Breathing   Apparatus (S.C.U.B.A.)   to   breathe   underwater.   This   enables   him/her   to   stay   underwater   for   a   longer   period   of   time   and   at   a   deeper   level   without   the need to constantly surface for air. While   it   can   bring   loads   of   fun,   it   can   also   be   a   test   of   the   mental   and   physical   fitness   especially   where   the   cardiovascular,   ENT   systems   are concerned.   One   has   to   be   physically   fit   and   has   normal   or   almost-normal   physiological   CVS   and   ENT   systems   to   enjoy   this   sport   fully   and also to avoid medical complications. The   cavities   in   head   &   neck,   namely   the   air-containing   paranasal   sinuses   or   the   middle   ear   (the   space   behind   the   eardrum)   can   be subjected   to   frequent   dynamic   atmospheric   pressure   changes.   Sinus   squeeze   or   the   middle   ear   squeeze   phenomenon   can   occur   as   a result   of   poor   conscious   equalization   efforts   on   the   diver’s   part   or   as   a   result   of   poorly-optimised   medical   conditions   involving   the   ENT systems.

The normal ear cross section. Notice the Eustachian tube which links the ear to the nose.

The normal ear drum as seen on a microscope or endoscope

Barotrauma effects on the ear: • Hemotympanum • Otitis media • Middle ear effusion • Perforation of the ear drum • Vertigo from inner ear pathology caloric stimulation, rupture of round window membrane Other ear conditions that can affect your diving pleasure includes: • Otitis externa (outer ear canal infection) • Exostosis • Expansion of the impacted ear wax causing pain • Uncontrolled nose allergy (allergic rhinitis)

The external ear canal (EAC)

Ear drum (normal)

Eustachian Tube

© Vincent Tan ENT

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This patient education is provided in good faith to help patients and their families learn more about their medical conditions, the options available to them and the possible consequences of their decisions. This information is not intended to be used for diagnosis, or treatment of any specific individual. Please consult with your ENT doctor regarding your particular circumstances.

More coming soon. Please check back soon for more updates...

ACUTE BAROTRAUMA TO EAR !

Notice the air fluid level denoting fluid in the compartment behind the ear drum

Notice the fluid  has slightly reddish tinge denoting blood stain in acute barotrauma