DescriptionComplete or partial hearing loss can occur for a variety of reasons. There are several diving-related causes including barotrauma, decompression sickness (DCS) and damage to the inner ear.
Hearing loss can be classified as conductive or sensorineural.
- Conductive hearing loss involves the ear canal, eardrum and tiny bones of the middle-ear ossicles; these anatomical components mechanically conduct sound to the inner ear, where electrical signals are generated.
- Sensorineural hearing loss involves the brain, the eighth cranial nerve or the inner ear.
Possible DiagnosesThere are many causes of hearing loss, including infection, blocked ear canal, barotrauma, drugs, trauma, round- or oval-window rupture, stroke, Meniere's disease, noise and medications.
Fitness to DiveAlthough uncommon, dive-related permanent hearing loss resulting from ear barotrauma or inner-ear DCS is possible. If the injury causes permanent unilateral (one ear only) hearing loss or impairment, most physicians will recommend against a return to diving. This is often recommended because if subsequent diving resulted in injury to the remaining functioning ear, the individual may experience permanent bilateral hearing loss. This recommendation applies to all monaural (one-sided hearing) individuals, regardless of the cause of unilateral hearing loss or impairment.
An additional population for whom diving is often discouraged or extreme caution is advised includes those who have undergone cochlear-implant surgery, ossicle surgery or tympanic-membrane repair (myringoplasty.) Diving places individuals with this medical history at risk of damaging the surgical repair, resulting in hearing loss. For divers who have undergone such procedures or suffered permanent hearing loss from ear barotrauma, extreme caution is often recommended, and close consultation with an ENT physician prior to diving is highly advised. For a referral in your area, email email@example.com, or call the DAN Medical Information Line at +1-919-684-2948.
It is important to mention that bilateral hearing impairment (either congenital or acquired) does not necessarily medically preclude someone from diving. However, in cases of bilateral hearing impairment, a diving environment may pose potential difficulties with surface communications, both with other divers and with crew members. Obstructed communications in cases regarding boat traffic, diver recall and other unforeseen circumstances may result in delayed emergency response, injury or death.