Anyone have an ear, nose and throat doctor in the Tampa area? I have some issues from diving last Thursday and need to get to a doc.

If you're a DAN member try them. I know they keep a database of ENTs with diving knowledge.

Call Dr. Edward Kampsen at 813-877-2685 who has an office down on Henderson Ave in South Tampa. He is about the best ENT in the city, but be forewarned that his bedside manner is not the best.

I would start with DAN. I tryed my docs recomendations and non dive ear docs and it was nothing but a waste of time and money. Upon my first visit to the DAN recomended doc, I instantly got answers and on track. I went to a ear doc at the U of Miami. It was a 100+ mile drive for me, but well worth answers that made sence.

I recommend Trina Espanola @ 727-553-7100 - She is an ENT with alot of experience in diving related ear issues. I myself saw her last Friday regarding a nagging ear issue from the SPO - she is straight forward no BS and as an active diver understands the issues. She is on DAN's list of ENT's and is very active in research related to diving issues. In my opinion you will not go wrong by seeing her.

Matt

John, call DAN and they'll give you the name and number of a ENT doc that is in St. Pete. I know because I've called before. Hope all is well.

Edit: I think that might be the lady (above) I was referred too by DAN.

John, did you blow out your ears trying to keep up with Jerry as he was racing to the bottom? :D

Dr. Kampsen is your best bet in Tampa. He is on Henderson just NE of Dale Mabry.
-Chris

Dr. Kampsen is your best bet in Tampa. He is on Henderson just NE of Dale Mabry.
-Chris

Yup. He took care of me awhile ago.

The lady in St. Pete is gone for a week. I went to the Tampa Bay Hearing and Balance center at Tampa General (the office building there).

To give you all some background, I came back from my Grounds trip last week basically dead in my left ear. I went to a walk in clinic Friday, and he sais I had an ear infection. It was not much better by yesterday, so I called DAN last night. They encouraged me to get in and get it looked at. Well, today they did a full audiogram and I have basically normal hearing in my right ear, and a severe loss in my left ear. In a nutshell, I can hear some sounds, but they are muffled, and I cannot hear any conversation in my left ear.

Anyway, I am now on a steroid therapy that they "hope" will bring it back. The guy at TGH gave me a 25% chance of getting it back. Holy Shit....
Anyways, I got home and called DAN and went over the results of the hearing test, etc... They were not nearly as dire in their prognosis. The guys gut feeling there was that I would probably regain hearing on the steroid therapy after a week or two. He said that the ENT guys are used to treating disease, not a traumatic injury to the inner ear.

The really baffling thing is that I do not recall having any real problems clearing, etc... I have no idea how this happened. I just have my fingers crossed now and its a waiting game.

I hope that you get your hearing back soon John.

Man, I hope everything works out for you John.

Get a big wad of Double Bubble bubble gum and chew until your jaws hurt.
Works your eu tubes, helps them drain and reduces swelling.
From personal experience, when the tube opens the hearing returns.
I recommend the watermellon flavor.

The lady in St. Pete is gone for a week. I went to the Tampa Bay Hearing and Balance center at Tampa General (the office building there).

To give you all some background, I came back from my Grounds trip last week basically dead in my left ear. I went to a walk in clinic Friday, and he sais I had an ear infection. It was not much better by yesterday, so I called DAN last night. They encouraged me to get in and get it looked at. Well, today they did a full audiogram and I have basically normal hearing in my right ear, and a severe loss in my left ear. In a nutshell, I can hear some sounds, but they are muffled, and I cannot hear any conversation in my left ear.

Anyway, I am now on a steroid therapy that they "hope" will bring it back. The guy at TGH gave me a 25% chance of getting it back. Holy Shit....
Anyways, I got home and called DAN and went over the results of the hearing test, etc... They were not nearly as dire in their prognosis. The guys gut feeling there was that I would probably regain hearing on the steroid therapy after a week or two. He said that the ENT guys are used to treating disease, not a traumatic injury to the inner ear.

The really baffling thing is that I do not recall having any real problems clearing, etc... I have no idea how this happened. I just have my fingers crossed now and its a waiting game.

Who was your Doctor at Tampa Bay Hearing and Balance?

If it wasn't Dr. Loren Bartels, he is the guy you want to see, he is probably the best hearing Dr. in the area, if not the United States.

The same thing happened to a buddy of mine down in the Keys. After about six weeks of tests and steroid treatments he is good to go.
The doctor told him to stop diving so deep and take up snorkeling.:lol:

The same thing happened to a buddy of mine down in the Keys. After about six weeks of tests and steroid treatments he is good to go.
The doctor told him to stop diving so deep and take up snorkeling.:lol:

Well, you are cheering me up, since I am about as depressed as you can get. The thought of my hearing not coming back makes me sick to my stomach. No way could I ever risk my other ear, so the thought that I may have dove for the last time ever is, well, a pretty shitty thought.

The DAN guy at Duke University thought their was a real good chance I would be just fine, so I am just hoping beyond hope that he is right.

Who was your Doctor at Tampa Bay Hearing and Balance?

If it wasn't Dr. Loren Bartels, he is the guy you want to see, he is probably the best hearing Dr. in the area, if not the United States.

My Doctor was Dr Christopher Danner, who is in the same office as Dr. Bartels. He is a fairly young guy, late 30' or early 40's.

My Doctor was Dr Christopher Danner, who is in the same office as Dr. Bartels. He is a fairly young guy, late 30' or early 40's.

You may want to see about getting an appointment with Dr. Bartels, if I had any hearing or ear problems he is the guy I would see.

Dr. Bartels is a client of mine, I am sure I have his office managers name and number somewhere if you need it, I called for an appointment for my oldest daughter who has a major hearing loss in one ear, and the appointment secretary said it would be 6 months before Dr. Bartels could see her, I called Dr. Bartels and he had his office manager contact me, and she was sitting in his office 2 days later.

You may want to see about getting an appointment with Dr. Bartels, if I had any hearing or ear problems he is the guy I would see.

Dr. Bartels is a client of mine, I am sure I have his office managers name and number somewhere if you need it, I called for an appointment for my oldest daughter who has a major hearing loss in one ear, and the appointment secretary said it would be 6 months before Dr. Bartels could see her, I called Dr. Bartels and he had his office manager contact me, and she was sitting in his office 2 days later.

Actually, if I do not notice improvement in the next couple of days, their is a specialist in Miami that teaches for DAN, I am going to drive to Miami and have him check me out.

All joking aside, I would be going up to Publix and buying a bag of Double Bubble.

John,

That sounds like a good idea, just don't take a Dr's word for it, be proactive in this situation or you may loose your hearing, the reason my daughter lost hearing in one ear was due to a Dr. (Actually a Nurse Practitioner, her Pediatrician was always too busy to see her) continually doing a half assed diagnosis of my daughter continual ear infections, it wasn't until I switched Pediatricians and my daughter saw a specialist did we realize how bad the situation was.

Do not blindly trust a Dr. just because they are a Dr.

DR. Edward Kampsen is the shit, He's been my ENT for the last couple of years. I wouldn't go to anyone else PERIOD. Even his PAC "Trent" is more knowledgable than most ENT's out there.Good Luck hope all turns out for the better.....

Damn John. I hope you make a full and speedy recovery. Aside from the possibility of having major hearing loss in one ear it's really scary to think that you had no clearing issues. As a kid I had very bad ear problems (two different sets of tubes, etc.) and in the back of my mind I always fear having some sort of ear trauma while diving. Did your hearing loss just come on gradually after diving or was more immediate? Just curious. Hope you get better soon.

Hope your OK John, the bubble gum thing couldn't hurt.

Holy shit John, hope it gets better for you soon. I know nothing about hearing loss, other than I have shitty hearing in general. If there is no physical damage to the ear, could it be a neurological issue? Let me know how it goes man, I didn't know you were having issues when I talked to you the other day. Hope it gets better soon.

Good Luck John,

Hope all goes well!

Well, I spoke with Dr Tom Barclay, the head of the ENT department at the University of Miami, and pretty much the preminant guy on diving ear injuries today. He teaches for DAN. I went over everything him, and he was not so dire. He says 2 out of 3 get a significant recovery, with 1 out of 3 getting a complete recovery. He said that even without a recovery, I could continue diving, just not nearly as aggresively as I have been doing. No 8 drop days in the middlegrounds anymore, stop diving at the absolute first sign of any clearing issues, etc... Based on what I am looking at now, never diving again, I would be fine with that scenario.

He did recommend that I get a steroid shot directly into my middle ear. I am contacting my doc tomorrow to get that done. My Doc was going to wait until the two week mark before doing that.

Well, that's definitely good news.
For what it's worth, I tore a hole in my eardrum during my open water checkout dive. I had a bit of trouble clearing and I didn't know any better and kept on descending. Eventually the ear cleared and I figured it was fine. I couldn't hear out of my left ear for 2-3 days. I saw the Dr. and he said I tore it, gave me steroids and anti-biotics and said to stay out of the water for 4-6 weeks and it would be fine. The hearing slowly came back. I've got a little scare tissue on it now, but nothing major.
It's interesting that you didn't have any pain or anything though. Good luck.

Well, its been a week today, and I have had some very minor improvement. If the room is quiet, I can check my voicemail (provided the caller is speaking clearly) with my left ear. Now, their is the possibility that that is just my right ear picking up the sound, so I do not really know what, if anything, I have gotten back. I am religiously following medical advice and have my fingers crossed.

Damn man I missed all this, I hope it improves! Did you try the double bubble? If you need snorkeling lesion's let me know,, I'm a PRO!:smthumbup:

John, email me the full size pic of your avatar. I have some UGA fans to harass.

I actually stole the avatar from Gatorsports.com, so I do not have it full size.

I moved this thread over here to the safety section

Holy crap, I missed this until now. Glad it's getting better.

Hey John, aside from all football kidding crap. I wish you the best. Sounds like you are getting there.

Got a new audiogram yesterday, they say no improvement. I don't understand why I can check voicemail now, couldn't 10 ten days ago, but I am showing as having not improved at all by the computer. It is still early, but obviously, this is not encouraging.

They have started injecting my inner ear with steroids, one shot yesterday, one today, and one tomorrow. I don't know what to expect at this point. The ENT at TGH is still pessimistic as hell. He says the ear right now is "useless" (thought that was a little strong, shit, I can check voicemail). The Doctors with dive related experience are still more optimistic. They say it can take weeks to return, and it is still early. It is clearly not a good sign that their computer says I have not gotten any better. I do get another audiogram today, and another tomorrow. They track it daily while they are shooting up my ear.

ah, Crap! I was hopin I would read you could hear today.

Just stay positive as you have. It seems as if you know you're hearing has improved from where you were at and I would take the "Dr's" pessimism with a grain of salt. Hoping for your full recovery John.

Well, just got back from todays trip to Palace of Pain at TGH. Another shot in the ear, yippee.

The GOOD NEWS - From yesterday to today I have a 15db improvement in my Audiogram. Thats not a ton, but it is definetely in the right direction. I am not trying to get my hopes up too high, but damn, after 12 days, this is the first morsel of good info I have gotten. I had about a ten minute conversation with my bro on the way home, with the phone on the bad ear. First time I have been able to do that in my truck, the diesel engine was previously making it too difficult. I could not talk to my wife very well though, her voice is a little on the high side.

I could not talk to my wife very well though, her voice is a little on the high side.

You say that like it's a bad thing. ;)

Seriously though, I am glad you are getting improvemnt in your hearing, it's about time we got some good news. :thumbup:

Just curious about the audiogram. You wrote computer a couple times. Is it an automated hearing test?

Sorry about your ear. I am studying to be an audiologist so I see a lot of peolpe with hearing loss and can sympathise. If it makes you fee any better I have four friends with a "bad" ear and with the exception of trouble in noisy environments they all lead normal lives. A little scary that it happened while diving and might jeoperdize your future diving.

Well, just got back from todays trip to Palace of Pain at TGH. Another shot in the ear, yippee.

The GOOD NEWS - From yesterday to today I have a 15db improvement in my Audiogram. Thats not a ton, but it is definetely in the right direction. I am not trying to get my hopes up too high, but damn, after 12 days, this is the first morsel of good info I have gotten. I had about a ten minute conversation with my bro on the way home, with the phone on the bad ear. First time I have been able to do that in my truck, the diesel engine was previously making it too difficult. I could not talk to my wife very well though, her voice is a little on the high side.

That's good news, John!!

I would bet that in a couple more weeks you will be fine...

:smthumbup:

Just curious about the audiogram. You wrote computer a couple times. Is it an automated hearing test?



Not totally automated, their is a lady (Doctor of some sort) running it, but all the noises are computer generated as she sits there at the keyboard.

Not totally automated, their is a lady (Doctor of some sort) running it, but all the noises are computer generated as she sits there at the keyboard.


What was that?? Speak into my good ear would ya.:)

Its a good thing you couldn't hear all the noises tonight.:D

Don't underestimate what I can pick up, BIATCH!!!

John, how is the ear now? Have you been coordinating with DAN to cover any of your expenses? Just curious since I just renewed my DAN coverage.

John, how is the ear now? Have you been coordinating with DAN to cover any of your expenses? Just curious since I just renewed my DAN coverage.It has actually improved alot in just the last week. Maybe 1/3 of the audible range is back to normal, and word recognition is up to 65%. I am not allowed to dive until the hearing in my ear stabilizes, and they then know exactly how much total loss I have. The loss will probably end up being fairly significant, I will be hard of hearing in that ear.

I did not bother with DAN on this, my United Healthcare has covered everything except the $20 copay at the doctors office.

It has actually improved alot in just the last week. Maybe 1/3 of the audible range is back to normal, and word recognition is up to 65%. I am not allowed to dive until the hearing in my ear stabilizes, and they then know exactly how much total loss I have. The loss will probably end up being fairly significant, I will be hard of hearing in that ear.

I did not bother with DAN on this, my United Healthcare has covered everything except the $20 copay at the doctors office.

That's all great news John. See ya on Saturday :beer::beer:

Well, just to throw an update out there. I went to the ear doc yesterday, and my left ear has improved to about 75% of what it once was. In both ears, I have a profound loss in the high ranges. Only a very small portion of the high range loss is in the audible range, the rest is higher than we speak at.

I am pretty much fine unless I am in a crowded room. When their is alot of crowd noise, I have a hard time engaging in a conversation, as the low pitch drone (where my hearing is perfect) overwhelms the higher pitch speach, where even in the audible range, it is less than perfect. Last week at the Winghouse, for example, I had a pretty hard time keeping up with conversations.

Now get this - the doc wants me to look at getting a hearing aid. I am not so sure about that, 98% of the time I am just fine, it is only in crowds that I have problems. I am going to a consultation after I get back from Colorado next week. We will see...

http://www.hearingplanet.com

Best deal in hearing devices

I got just the thing for ya!!! :D


http://www.oldcatablog.com/wp-content/uploads/2007/08/eartrumplb.png

The benefit of hearing devices...a golden selective hearing excuse. ;)

google "inner and outer ear barotrauma"

ENT's are use to prescribing medication for people who dont dive

when someone comes in with an inner ear or outer ear problem the symptoms are usually the same but the course of treatment is usually different. just make sure they know you did this while diving.

google the words above and next time you see them ask them about some of the injuries you will soon read about if you google it and research it alittle. if they have no idea what you are talking about and say its an infection get another doctor.

google "inner and outer ear barotrauma"

ENT's are use to prescribing medication for people who dont dive

when someone comes in with an inner ear or outer ear problem the symptoms are usually the same but the course of treatment is usually different. just make sure they know you did this while diving.

google the words above and next time you see them ask them about some of the injuries you will soon read about if you google it and research it alittle. if they have no idea what you are talking about and say its an infection get another doctor.

Did you read any of this thread??????

2 words....Colloidal Silver! :D

2 words....Colloidal Silver! :D


OK Shitstick.


http://www.youtube.com/watch?v=3XV0I6Q70Yw

OK Shitstick.


http://www.youtube.com/watch?v=3XV0I6Q70Yw

Papa smurf can't be wrong. :D

what diagnosis did they give you? Here's what i found, pretty extensive differential diagnosis. Makes you really take equalizing slowly and completely more seriously. Good luck with your recovery.


Middle ear barotrauma, tympanic hemorrhage or perforation, or inner ear barotrauma(Cochlear Damage resulting in intracochlear and intralabyrinthine hemorrhage, perilymphatic fistula formation, and secondary to the formation of gas bubbles beneath the round window).

When the eustachian tube is forced open suddenly, an acute rise in middle ear pressure will result causing an inward bulge of the round window and an outward bulge of the stapes foot plate. If the force is strong enough, implosion of the round window and a secondary outward pull on the stapes footplate may occur.

If the eustachian tube is blocked, a valsalva maneuver will cause an elevation of CSF pressure which will be transmitted through a patent cochlear aqueduct or internal auditory canal causing a rise in the intracochlear pressure. If the difference between the perilymphatic space is sufficiently greater than the middle ear pressure, an explosive rupture of the round or oval window ligament will occur.

The treatment of IEBT secondary to damage to the membranous labyrinth and cochlea includes bed rest with head elevation, the use of vasodilators, steroids, histamine, and carbogen, in an effort to decrease inflammatory changes and increase the delivery of oxygen. Parell et al have shown that if proper precautions are taken to maintain proper eustachian tube function, no further deterioration takes place in hearing if a patient returns to diving after experiencing cochlear IEBT.

Inner ear decompression sickness (IEDS) is a form of nontraumatic cochlear damage and is the result of gas bubble formations within the inner ear. It is commonly seen after dives to extreme depths using a Helium oxygen mixture as a substitute for nitrogen oxygen mixture, in order to minimize the narcotic effects of nitrogen.


The differentiation between IEDS and IEBT can be made based on the following criteria.

* Dive profile:
1. IEDS is rare in shallow water (only 3 cases reported in less than 100 feet of water),
2. diving to a depth that is near the limits of the nodecompression zone and not undergoing decompression,
3. using a HE-02 gas mixture (IEDS),
4. h/o rapid ascent. (IEBT associated with rapid descent);
* Time of symptom onset:
1. During descent (IEBT),
2. During ascent (IEDS),
3. Shortly after decompression (IEDS);
* Associated symptoms:
1. the presence of decompression sickness (only 6 cases in literature of IEDS without systemic decompression sickness),
2. h/o difficulties in clearing the ear (IEBT),
3. h/o nasal or sinus problems (IEBT);
* Physical findings:
1. MEB (IEBT),
2. Central neurologic signs (IEDS).

what diagnosis did they give you? Here's what i found, pretty extensive differential diagnosis. Makes you really take equalizing slowly and completely more seriously. Good luck with your recovery.


Middle ear barotrauma, tympanic hemorrhage or perforation, or inner ear barotrauma(Cochlear Damage resulting in intracochlear and intralabyrinthine hemorrhage, perilymphatic fistula formation, and secondary to the formation of gas bubbles beneath the round window).

When the eustachian tube is forced open suddenly, an acute rise in middle ear pressure will result causing an inward bulge of the round window and an outward bulge of the stapes foot plate. If the force is strong enough, implosion of the round window and a secondary outward pull on the stapes footplate may occur.

If the eustachian tube is blocked, a valsalva maneuver will cause an elevation of CSF pressure which will be transmitted through a patent cochlear aqueduct or internal auditory canal causing a rise in the intracochlear pressure. If the difference between the perilymphatic space is sufficiently greater than the middle ear pressure, an explosive rupture of the round or oval window ligament will occur.

The treatment of IEBT secondary to damage to the membranous labyrinth and cochlea includes bed rest with head elevation, the use of vasodilators, steroids, histamine, and carbogen, in an effort to decrease inflammatory changes and increase the delivery of oxygen. Parell et al have shown that if proper precautions are taken to maintain proper eustachian tube function, no further deterioration takes place in hearing if a patient returns to diving after experiencing cochlear IEBT.

Inner ear decompression sickness (IEDS) is a form of nontraumatic cochlear damage and is the result of gas bubble formations within the inner ear. It is commonly seen after dives to extreme depths using a Helium oxygen mixture as a substitute for nitrogen oxygen mixture, in order to minimize the narcotic effects of nitrogen.


The differentiation between IEDS and IEBT can be made based on the following criteria.

* Dive profile:
1. IEDS is rare in shallow water (only 3 cases reported in less than 100 feet of water),
2. diving to a depth that is near the limits of the nodecompression zone and not undergoing decompression,
3. using a HE-02 gas mixture (IEDS),
4. h/o rapid ascent. (IEBT associated with rapid descent);
* Time of symptom onset:
1. During descent (IEBT),
2. During ascent (IEDS),
3. Shortly after decompression (IEDS);
* Associated symptoms:
1. the presence of decompression sickness (only 6 cases in literature of IEDS without systemic decompression sickness),
2. h/o difficulties in clearing the ear (IEBT),
3. h/o nasal or sinus problems (IEBT);
* Physical findings:
1. MEB (IEBT),
2. Central neurologic signs (IEDS).


somebody did their homework. it pays to be educated.

what diagnosis did they give you?

IEBT

If Ballsdeep had actually read this thread, he would know that.

Im sorry I did not have time to read it all. Just read the initial and last couple of threads. Just trying to help...

somebody did their homework. it pays to be educated.

WOW this internet thing is going to put Physicians out of business;)


Seriously though. That is a great one paragragh summary of some of the forms of inner ear and middle ear barotrauma and the theoretical ways in which they can occur. The REALITY is that it is extremely difficult to make a differential diagnosis and even with all the amazing imaging techniques and diagnostic tests now available it is usually not possible to know what caused the hearing loss or even if the hearing loss is dive related. I see patients all the time with sudden onset hearing loss who dont dive.

I agree that being educated about your health is important but in the end you must trust the profesionals.

I am glad you have recovered so much of your hearing spearchucker. Most people take their hearing for granted and have no appreciation for the struggles of the hearing impaired.

I am a Ph.D student in Audiology.

WOW this internet thing is going to put Physicians out of business;)


Seriously though. That is a great one paragragh summary of some of the forms of inner ear and middle ear barotrauma and the theoretical ways in which they can occur. The REALITY is that it is extremely difficult to make a differential diagnosis and even with all the amazing imaging techniques and diagnostic tests now available it is usually not possible to know what caused the hearing loss or even if the hearing loss is dive related. I see patients all the time with sudden onset hearing loss who dont dive.

I agree that being educated about your health is important but in the end you must trust the profesionals.

I am glad you have recovered so much of your hearing spearchucker. Most people take their hearing for granted and have no appreciation for the struggles of the hearing impaired.

I am a Ph.D student in Audiology.

I would beg the differ. This is in no way a slam/flame. So dont take it personal. This is all diver related. I am in no way an ENT, or doctor for that matter. I am sure people who don't dive can have sudden hearing loss and some of the other symptoms that go along with diving related injuries, but they in no way can have a diver related injury unless diving.

It is possible to know if it is diver related. Usually if it happens after diving it is diver related. But here's some of my thoughts...

**middle ear squeeze**, most common in diving, symptoms are experienced during and after diving, if you experience them after diving say 72 hours more than likely it happened due to diving.

pain, fullness, hearing loss, or even mild vertigo. sometimes bloody nose due to blood being forced out of the middle ear space and into the nasal cavity through the eustachian tube. this is usually handled by an ENT.

**inner ear barotrauma**usually results in the round window busting into the middles ear, which is most common type we see, it is called inner ear barotrauma with perilymph fistula.

primary sysmptoms of IEB are persistent vertigo and hearing loss.

symptoms usually occur abruptly during descent, often as the diver reached bottom and does a final equalization.

treatment ranges from bed rest to exploratory surgery, depending on severity of symptoms. ENT can make diagnosis.

if within 72 hours of diving it is more than likely caused by diving.

***THIS IS WHERE IT DIFFERS*** (TREATMENT DIFFERS)

inner ear DCS (type II DCS)

tinnitus, hearing loss, vertigo, dizziness, nausea, and vomiting.

re compression therapy is needed.

A ENT does not usually treat this. A neuro is usually performed, along with dive profile and any problems that occurred while diving, to diagnose this type of diving related injury.

If any of this occurs after diving then it is diving related, more than likely you will have other symptoms along with inner ear DCS symptoms to diagnose it as Type II DCS.


I do not have a Ph.D in audiology, and i am not a doctor but i am professional diver and I know diving and know how to diagnose and treat most diver related injuries. But for your recreational diver, being educated helps when you do see a doctor, because many doctors if not all have no formal dive medicine training. I would agree with you that a professional and only a professional should diagnose and treat you.

I would beg the differ. This is in no way a slam/flame. So dont take it personal. This is all diver related. I am in no way an ENT, or doctor for that matter. I am sure people who don't dive can have sudden hearing loss and some of the other symptoms that go along with diving related injuries.

It is possible to know if it is diver related. Usually if it happens after diving it is diver related. But here's some of my thoughts...

**middle ear squeeze**, most common in diving, symptoms are experienced during and after diving, if you experience them after diving say 72 hours more than likely it happened due to diving.

pain, fullness, hearing loss, or even mild vertigo. sometimes bloody nose due to blood being forced out of the middle ear space and into the nasal cavity through the eustachian tube. this is usually handled by an ENT.

**inner ear barotrauma**usually results in the round window busting into the middles ear, which is most common type we see, it is called inner ear barotrauma with perilymph fistula.

primary sysmptoms of IEB are persistent vertigo and hearing loss.

symptoms usually occur abruptly during descent, often as the diver reached bottom and does a final equalization.

treatment ranges from bed rest to exploratory surgery, depending on severity of symptoms. ENT can make diagnosis.

if within 72 hours of diving it is more than likely caused by diving.

***THIS IS WHERE IT DIFFERS***

inner ear DCS (type II DCS)

tinnitus, hearing loss, vertigo, dizziness, nausea, and vomiting.

re compression therapy is needed.

A ENT does not usually treat this. A neuro is usually performed, along with dive profile and any problems that occurred while diving, to diagnose this type of diving related injury.

If any of this occurs after diving then it is diving related, more than likely you will have other symptoms along with inner ear DCS symptoms to diagnose it as Type II DCS.


I do not have a Ph.D in audiology but i am professional diver and I know diving and know how to diagnose diver related injuries. Being educated helps when you do see a doctor, because many doctors if not all have no formal dive medicine training. I would agree with you that a professional and only a professional should diagnose and treat you.




I dont want to get into an internet debate over whether it can be diagnosed as dive related or not because it doesnt really matter. You are correct that if it occurs during a dive or immediately following a dive it is likely dive related. The problem with a statement like :

"inner ear DCS (type II DCS)

tinnitus, hearing loss, vertigo, dizziness, nausea, and vomiting"

is that I see patients everyday who wake up one morning with these symptoms and they certainly dont have inner ear DCS. I could make you a list of at least 10 pathologies with these symptoms and pinpointing a specific cause is usually impossible. I work at an ENT office and I do hearing and vestibular testing all day long (including tests for perilymph fistula) before and after the patients recieve treatment so I know a lot about diagnosing the cause of hearing loss and vestibular disorders.

I just wanted to point out how difficult barotrauma and dive related inner and middle ear disorders can be and to caution against self diagnosis based on the INTERNET. (not that you would do that)

I dont want to get into an internet debate over whether it can be diagnosed as dive related or not because it doesnt really matter. You are correct that if it occurs during a dive or immediately following a dive it is likely dive related. The problem with a statement like :

"inner ear DCS (type II DCS)

tinnitus, hearing loss, vertigo, dizziness, nausea, and vomiting"

is that I see patients everyday who wake up one morning with these symptoms and they certainly dont have inner ear DCS. I could make you a list of at least 10 pathologies with these symptoms and pinpointing a specific cause is usually impossible. I work at an ENT office and I do hearing and vestibular testing all day long (including tests for perilymph fistula) before and after the patients recieve treatment so I know a lot about diagnosing the cause of hearing loss and vestibular disorders.

I just wanted to point out how difficult barotrauma and dive related inner and middle ear disorders can be and to caution against self diagnosis based on the INTERNET. (not that you would do that)

I understand where you are coming from. The only thing i can say though is that you can only get inner ear DCS from diving. I thought I was making it clear that in order to have inner ear DCS you must be diving, and that you would have other symptoms relating to type II DCS. sorry for the confusion. i was combining your post and someone else's post about seeing an ENT for diving related ear problems, and that an ENT would not diagnose inner ear DCS because he/she usually does not deal with this type of injury, yet most people would go see there ENT if they had this problem not knowing that they had type II DCS from diving and not just an ear infection or whatever. The only reason i am saying this is because I have treated civilians for inner ear DCS that went to an ENT and the ENT said it was something else, then when symptoms got worse or didn't go away, the civilian said he had dived a couple days before and well that is when I got called to treat DCS. and no i would never tell someone to self diagnose themselves. The information I am providing is just to educate a recreational diver on the seriousness of diving related injuries, and that they should seek medical attention if it happens to them, also being educated could help you find the right doctor sooner, as many make the mistake of seeing a general physician instead of a specialist, or a doctor with knowledge in diving related injuries.

I am pretty sure i made it clear that we were talking about diving. I dont know why anyone would say they have type II DCS (inner ear DCS) if they hadn't been diving.

Am i overlooking or missing something here? I guess i should put diving as a symptom next to nausea and vomiting?

One tool for diagnosing soem inner ear type issues has been left out(from what I read here). A Catscan of the ear. I know this becasue I just got one Friday. I have had issues with one ear and it screwed up on me again about 3 weeks ago. Vertigo upon accent. I can survive the Vertigo, but I could tell something was hurt in the middle ear so I aborted diving until I figure it out. No loss of hearing but a little sensitivity for about a week. I went straight to the U of Miami docs this time, and they think it may be a Perilymph Fitsula type thing. If one of those inner ear windows pops, it lets the fluid out into the middle ear. If the fluid is not in there, where it's supposed to be, a Catscan can show it. I should know in a few days when the docs see the results. I talked to the doc and he said 1st if it appears fine, it already could have healed on it's own and refilled. So, if it happens again, I should get a catscan as soon as possible. Like in a day or two vs a couple weeks. It takes a few weeks to get a appt with these highly skilled docs there in Miami.
So now I wait for the diagnosis from the Catscan. If nothing can be seen from that, I wait a few more weeks to let the ear heal up(feels fine now)good, dive and hope for no issues. If I have issues, get a Catscan ASAP and make a aapt with the super docs. He said if it happens again they may do exploritory surgery even if the catscan shows nothing.
I could take for hours about this. This is my second time around with Vertigo upon accent. The first time I was diagnosed with DCS and had alot of the same symptoms with the same ear. This time around it is definatly not DCS. It is not known if the ear had inner ear baratroma the first time or not. This time inner ear baratroma symptoms are the only symptoms. I actually had very little symptoms afterwards but just enough to make me seek medical advice. If my ear did not feel slightly sensitive for the couple days afterwards I would have had zero symptoms after the Vertigo thing. I'm not sure if the first issue was Inner ear DCS or not but it was defiantly DCS the first time(shoulder pain and other symptoms) along with the ear issue. This time the dive profile and symptoms do not point at DCS even a little. Inner ear DCS is usually a deep diving technical diver thing, which I am not. So my episode looked somewhat like Inner ear DCS but they say it probably was not actually that.
As has already been stated: Inner ear damage is not easily determined. I have no balance issues and no reoccuring vertigo or anything, but they think it still could be a ruptured window. Some people could be completely down due this type of injury. So it varys to the max, and you can't just say this means that. Thus "exploritory surgery" is the real point of decision. Either your problems demand exploritory surgery, or you survive without it and guess what happened. Virtually everything prior to exploritory surgery is discussion of symptoms and guesses.