DAN Medical Frequently Asked Questions

Dealing With Ear Problems

I have been certified for four years but do little diving since I burst a blood vessel or perforate an eardrum once or twice a year. This always occurs in the same ear. The easiest way for me to equalize is to swallow, but sometimes my mouth is dry. I have to try several times to equalize. Sometimes I have no problems on the first dive, and then on the next dive it seems I will never be able to equalize. I may go days before a problem occurs. I don't know if I am trying too hard, nervous or don't concentrate. I only know that it worries me and takes a lot of joy out of diving for me and my husband.

Difficulty equalizing the air spaces of the middle ear and sinuses is the most common problem and injury among recreational divers. If you're experiencing problems with equalizing, the first thing to do is consult with your personal physician or an ear, nose and throat specialist who can evaluate your problem. Believe it or not, it may be something as simple as a chronic inflammation from allergies to household plants or pets. The irritation and inflammation resulting from an allergy can narrow the air passages and restrict the flow of air in and out of the middle ear.


Your problem may also be from damage to your eustachian tube from an infection that occurred years ago. There may not be anything your physician can do for such a chronic problem, but decongestant medications may be available that can shrink swollen tissue and allow air to move freely in and out of the middle ear space. Your physician can assist you in finding the best and most effective medication for you. You may have to try several. Some doctors recommend certain nasal sprays that also help shrink chronic swelling in the mucus membranes, but these are short-term solutions that can be used a limited number of times. Additionally, you will need to consider the possibility of side effects any nasal spray or decongestant medication may produce.


Finally, remember to clear before you get into the water. This helps you to make sure you don't have a problem that could be corrected at the surface before you dive, such as taking a drink of water to keep your mouth moist. You may need to simply add something new to your current clearing technique, such as clearing as often as every 1 to 2 feet/0.3 to 0.6 meters in order to prevent further injury. Make sure that when clearing you do it gently and before the problem becomes severe. Waiting too long will cause unnecessary pain, and a forceful clearing attempt by pinching your nose at that time may cause middle ear damage. Several gentle maneuvers and switching back and forth between swallowing and pinching your nose and gently blowing may be the ticket to a trouble-free dive. Above all, if you cannot equalize, then abort the dive.