![]() The inability to equalize the middle ear space effectively, or an attempt to do so too forcefully, may dislocate the prosthetic stapes.ĭislocation can be corrected only in surgery and may result in permanent hearing loss.ĭiving after a stapedectomy also carries the risk that the desolation of the prosthesis may damage the round or oval window of the cochlea. With that said, the consequences of failure to equalise can be greater for those who have undergone stapedectomy procedures. The results from these samples indicate that the subjects are not at an increased risk of injury when compared to the control groups of divers, provided they can safety equalize their ears and sinuses with the changes on ambient pressure. ![]() Limited studies have described small numbers of people diving after stapedectomies. While some ENT experts absolutely recommend against diving for individuals with existing ear issues, other ENT experts are of the opinion that patients who understand and accept the potential risks may dive. This controversy extends to diving with any ear condition that increases the risk of permanent injuryĪll of us who dive place our hearing at risk and barotraumas (a pressure injury) of the middle and/or the inner ear increases the risk of hearing loss. Exhaling through the nose during descent (as done naturally, for example, with the Valsalva equalisation technique) will minimise the risk of facial barotrauma. The best treatment for mask squeeze is prevention. These symptoms are rare with mask squeeze. The individual’s appearance may worsen before improving.Ī physician or an eye specialist should immediately address any eye pain or visual disturbances, such as blurred vision or partial loss of the visual field. The body will eventually reabsorb the ecchymosis and edema. The injuries from a mask squeeze can take up to two weeks or more to resolve. Unless there is eye pain or visual problems present, there is no specific treatment for facial barotrauma. The eyes themselves may appear bloodshot. The soft tissue around the eyes swells (periorbital edema) and discolours, manifesting as redness or bruising (ecchymosis). This is referred to as “mask squeeze”, which can cause varying degrees of barotrauma to the soft tissues of the face and eyes. The negative pressure, in effect, creates suction. So prevention of a middle-ear barotrauma is best achieved by avoiding nasal decongestants and by training the diver in correct middle-ear equalization techniques during descent. The steroid, fluticasone propionate, and similar medications, on the other hand, are intended to be used over substantially longer periods of time than decongestants. Another disadvantage of decongestants is that they are only intended for short-term use and may lose effectiveness with habitual use. Unlike decongestants, steroids do not act as vasoconstrictors, so there is no rebound. The after effect is that the blood vessels will swell and may become more engorged with blood that before, which is known as the rebound-effect. When the decongestants wear off, however, the blood vessels are no longer constricted. ![]() The mucous membranes lining these structures are vascularised and decongestants provide a short-term solution to congestion by constricting the blood vessels in the mucous membranes, which decreases swelling. The swelling and inflammation of the cells lining the Eustachian tubes, middle ear space and sinuses may lead to occlusion and barotrauma. Even though the fast-acting nature of decongestants can be appealing, there are several reasons why steroids may provide a safer option.
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