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Ear preassure equalization

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Ear preassure equalization

Post Number:#1  Postby Ketam » Tue Apr 26, 2011 8:16 pm

Many people experience severe ear pain, even when diving in a swimming pool, and automatically assume that they will have to deal with the same situation while scuba diving. This can easily be avoided if the techniques of ear pressure equalizing are correctly applied.

As one dives deeper, the water pressure increases and it is therefore extremely important for divers to equalize their ears to prevent serious damage, such as rupturing of the eardrum, while diving.

The ear consists of 4 basic structures. The outer ear, which is open and filled with air, experiences the same pressure as the outside environment. The middle ear is air-tight and air moves in and out through the Eustachian tube. The Eustachian tube links the ears to the nose and throat. If the Eustachian is open, the air flows from the nose and throat into the ears. Usually the air in the middle ear is trapped, as the Eustachian tubes are generally closed. The eardrum divides the outer and middle ear and consists of a thin tissue.

The pressure on the outer ear increases as a diver descends due to the fact that the outer ear is affected by the pressure of the surrounding environment. The pressure in the middle ear stays unchanged and this pressure difference between the outer and middle ear creates pressure on the eardrum. This is commonly referred to as “ear squeeze" and causes the eardrum to bulge away from the higher pressure, leading to the bursting of the eardrum with extreme pain, a ringing sound in the ears and sometimes even blood in the ear canal.

Ear pressure equalization during the descent of a dive is therefore vital and can be achieved by opening the Eustachian tube and allowing the higher pressure from the throat to enter the middle ear. Through this process, the pressure on the eardrum is equalized and leads to a "popping" sound.

There is no definite rule as to how often a diver should perform ear pressure equalization. It is however important, to equalize prior to any pain or discomfort, and it is generally recommended that equalizing should be done continually during the descent.

There are various techniques used for ear pressure equalization during descent. When using the "Valsalva Maneuver", the nostrils are pinched closed and the diver should blow softly through the nose. The "Frenzel Maneuver" is similar to the "Valsalva Maneuver" but one should swallow at the same time.

It is not generally necessary for divers to be concerned with ear pressure equalization when ascending but if the ears are not equalizing automatically the diver may experience discomfort when the eardrum moves outwards. This is known as "reverse block" or "reverse air squeeze" and can be accompanied by dizziness (alternobaric vertigo) which is caused by only one ear equalizing. To solve this problem, try using the "Toynbee Maneuver" which is used for ear pressure equalization on ascent. The diver should pinch the nose closed and swallow, sucking any air pressure out of the middle ear.

Scuba diving is not recommended for anyone suffering from any upper respiratory tract infections or severe nasal allergies, as the Eustachian tubes will become blocked by mucus and could inhibit successful ear pressure equalization. If one is subjected to rapid pressure changes when suffering from a sinus infection, the result is often extremely painful and can extend from the ears to the head and even the eyes, causing splitting headaches and severe ear pain, it can even lead to the ear drum bursting.

From : Divetime

Ketam initially had a lot of problem equalizing. A good advise received was to practice equalization the day before a dive. Make sure you are able to equalize on land. Another advise is never try to push it. If you can't equalize, ascent a meter or so and try again. Sometimes ascending to the surface and clearing your nose will help.

Happy diving!
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Re: Ear preassure equalization

Post Number:#2  Postby justjim » Wed Apr 27, 2011 3:38 pm

I'll like to share some experience here as well while we're on the subject of ear equalization (though my story only slightly touch upon equalization).

What happened:
I've punctured my eardrum three times (well, four if you count perforation after surgery). The first was a water sport accident resulting in a surgery, the second time was during a shallow dive (max depth 5m) which also resulted in surgery while the third (also a shallow dive, but happened before I reach max depth of 5m) healed by itself with a healthy dose of prescription ear drops and medications.

How to tell when your drum pops while underwater:
Simple really, though you may not feel a pain prior to popping, EVERYTHING starts to spin and you will loose orientation. Mask will continue to flood while descending (as water will be entering through your ear and exit through your nose, gross I know). You will however feel the pain when the water is passing through. After which you will not feel pain anymore until there is a change in pressure (depth) again. Obvious sign that your buddy has popped his/ her eardrum: bubbles coming out through the ears and not the reg.

How it happened (for me anyway):
Apart from the first accident, both times when it happened during my dive were most likely due to infection. According to my doc's diagnosis, both time during the dive trip prior to the puncture, I was having a sore throat (both time over in Lembeh, where I was having a blast with the local sambal for all my meal), which leads to a throat infection. This ultimately leads to the weakening of the ear drums. In some cases, some people might even get a perforation of the ear drum due to sore throat even without entering the water. So in my case, it was an aggravation (due to pressure while uw) on an already weaken eardrum that leads to the inevitable.

The moral of the story:
Stay away from sambal when diving, hahaha.... On a more serious note, I never had equalization problem since I started diving back in the late 90s, which led to my ignorance and ultimately a costly (the surgery cost nearly RM5k if done with local anesthetic, and no, your insurance don't cover dive accident unless you have DAN insurance) experience. Therefore it is surmise to say that if you have a sore throat, or even an ear infection, please be careful if you wanna go diving, because once the ear drum is weaken, you don't need to dive deep before your drum pops!

Hopefully someone will find this useful. Always wanted to share but always been too lazy to write until I saw this article. So there you go...

Dive safe!

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Re: Ear preassure equalization

Post Number:#3  Postby run » Wed Apr 27, 2011 3:51 pm

A very good topic to read.
I know some of the divers taken this problem very lightly
and for them it is just a simple pain in the ear and a little
headache that will go away with a few pain killers.

Some divers when they saw their DM already at the bottom, they
quickly try to decends as fast as they could in order to catch up
with the DM and the other divers at the bottom.
Pain or not , they push themselves just so they wont be left behind.
I was one of them back a few years ago..

Of coz if follow by the book , the DM should wait until all the divers have re-group at the bottom..
but who wants to wait for a diver and the buddy dangling2 trying to clear the ear problem until god knows when.
So divers with ear problem…don’t panic when you see other divers already reach 17m and
You are still stuck at 5m..
If the viz is clear and you can see the rest of them just follow them from above.
Acknowledge the DM that you will follow from above (best told them earlier before entering the water)
Decends slowly ..and i do say slowly..
When you feel the pain , go up a bit…then try again..while doing this..
Do not loose the divers from your sight..if you cant see them..then follow their bubbles.
Little by little you will go down.
But If you don’t feel confident enough to do this or your ear still pain , then just abort the dive.

Some divers say best to avoid diving when you have a running nose.
But tell me if the instructor or DM have a running nose  when you plan to take your license or
For a leisure dive, will they say “no diving” today to the customer just because they have a minor flu?
Many of you guys have read , some divers take clarinese , clarantine the night before the dives.
What if your nose still problem the next morning, so like I said above, try going down slowly, slowy and very slowly..
When you start to feel the pain, go up a bit and then decends slowly.
If the pains still unbearable , then abort the dive. Or you totally not confident enough to do this. Don’t pressure yourself to dive.
I learned a remedy by eating cilipadi will open the blockage during flu.
I tried it and it works. Though each tip and tricks of diving depends on each individual.
Probably eating cilipadi works well for me but It might not work with another diver.
This is only apply to divers who has minor flu and not a high fever and divers who are
Not scared eating cilipadi. Other than that  a few precautions when diving with a running nose,
your mucuos will start to form inside the mask and
So you may need to open your mask underwater and midly sneeze out the mucuos.
Sometime your saliva will feel very sticky and it will make you feel uneasy to breath through
Your 2nd stage and so you may need to cough out your saliva and if you are in a panic situation you will think
You will be choking to death with your own saliva. Remember how to do 2nd stage recovery? Where you
Count to 3 and then take a deep breath , take out your 2nd stage and bubbles?
Yeap you do the same thing to cough out that sticky saliva. Or you can do it while the the 2nd stage in your mouth.
What ever comfortable to you.
Again you need to have water confident about doing this.
Please be aware that I don’t encourage people to go diving while having a flu or a running nose.
Just that there are ways to over come a few problem but it does involves some risk.

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