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Ear Pain, Scuba Diving

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Diving Ear Pain Symptoms

Pressure against the eardrum is responsible for the symptoms of ear squeeze. At low pressure, the diver has a feeling of fullness. As the pressure increases, the eardrum bulges inward, swells, and becomes painful.

Continued high pressure can rupture the eardrum. If this occurs, air bubbles may be felt coming from the ear and the pain may lessen. Cold water then enters the middle ear through the hole in the eardrum, and the diver may become nauseated or vomit. The diver may also become disoriented or have a feeling of spinning, referred to as vertigo.

Upon returning to the surface, if the ear drum has ruptured, the diver may feel fluid draining out of the ear or notice hearing loss. Rarely, a one-sided facial paralysis resulting from too much pressure on a nerve in the inner ear may be associated with ear squeeze.

When to Seek Medical Care

The majority of cases of ear pain or ear squeeze force the diver to abort the dive before the eardrum ruptures. In these cases, symptoms often resolve shortly after the diver reaches the surface. If symptoms continue or the cause of the ear pain is not known, seek medical care. Disorientation, vomiting, and hearing loss are symptoms of a ruptured eardrum and require medical care.

If a ruptured eardrum is present or suspected, the diver should be evaluated in a hospital's emergency department. No further dives should be undertaken until the diver is medically cleared.

Exams and Tests

The physician will evaluate the possibility of ear squeeze with a series of questions regarding the dive. These questions not only help diagnose the ear squeeze but also detect other potential dive injuries.

  • Did the diver experience difficulty clearing the ear?
  • Did the symptoms begin during descent or ascent?
  • Were the symptoms present during the dive or after reaching the surface? 
  • How long did the symptoms last? 
  • Is there a history of ear or sinus infections?

The physician will then examine the ear with an otoscope or ear scope. The exam may reveal a normal eardrum, swelling and redness of the eardrum, or a hole in the eardrum. Hearing loss or facial paralysis may also be present. X-rays and blood tests are not needed.

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