NOTE: A related syndrome can occur as the patient ascends due to a relative overpressure in the middle ear (reverse squeeze).
Risk factors:
(1) obstructed Eustachian tube, often due to a cold or allergy
(2) middle ear infection
(3) mass lesion in the middle ear
One or both ears may be affected.
Signs and symptoms:
(1) ear pain
(2) bloody otorrhea
(3) vertigo
(4) hearing loss and/or tinnitus
In severe cases the ear drum may rupture, in which case water can reach the middle ear.
Management:
(1) A person should not dive until all symptoms related to the ears have cleared.
(2) Decongestants may help reduce blockage associated with viral infections or allergies.
(3) Antibiotic therapy may be indicated if there are signs of otitis media.
(4) Analgesics can help relieve acute pain.
(5) Keep the external ear canal free of obstructions (cerumen and foreign bodies).
(6) The pain can be relieved by ascending a few feet in the water. If the symptoms improve then the diver can attempt to resume the dive.
