>Other contributing factors may be a history of sinusitis, allergies and childhood ear infections. Any chronic irritations or infections may damage the soft tissue lining (mucous membrane) of the sinuses and especially the Eustachian tube, connecting the middle ear with the pharynx. A deviated septum can also cause difficulty in clearing. Divers who continue to descend when they cannot equalize pressure risk several consequences: pain, fluid accumulation and bleeding into the cavity, whether it is the ears or the sinuses. Infection of the fluid can ensue; and persistence of fluid in the middle ear is one possible reason for impaired hearing. Rupture of the eardrum can also occur, and more serious is damage to the small membranes in the inner ear: the round or oval windows.
>Although spontaneous healing of these structures can occur, and surgical repair may be possible, permanent loss of hearing can result. Over-the-counter medication used for the symptoms of congestion can be very effective for some divers and can help with pressure equalization. However, the mucous membrane may not fully recover from a viral infection or head cold for several weeks after initial symptoms begin - this is why DAN advises divers not to dive with any symptoms of a cold.
>When barotrauma has occurred in the middle ear, it is not unusual for the diver to have a sensation of pressure or fullness and decreased hearing. Ringing (tinnitus) represents the stimulation of the nerve fibers responsible for interpreting sound. In your case, a similar episode of barotrauma could lead to further damage and additional impairment. Your physician may probably feel that this risk is not worth taking, and you will have to consider whether some degree of permanent hearing loss is an acceptable risk for you. DAN recommends that divers wait until symptoms of viral illnesses and head colds have completely resolved before planning a dive. Although decongestant medications may be helpful in salvaging a diving vacation if symptoms are mild, they do not necessarily prevent serious sinus or ear barotrauma. If you cannot equalize pressure in the middle ear cavities or sinuses, you should not continue to descend.
>DAN Safety Tip:
>It's always a good idea to "pre-clear" before you go under: hold your nose and swallow to see if you get that characteristic release.