Scuba diving and the risks for the ENT sphere
Scuba diving or snorkeling is a very personal experience. For some people it is a passion, for others a holiday leisure activity, and for the more adventurous ones even a job. However, this sport is attracting an increasing number of followers and with them an increasing number of accidents, mostly of which due to a lack of awareness or non-compliance with basic safety rules. The accidents or injuries that may occur are countless and many of them concern the different parts of the ear, because this organ is particularly stressed while diving.
In addition to ear barotrauma, which affects 30% of divers during their first dive and 10% of experienced divers, other injuries can occur:
• decompression accident to the inner ear
• sudden deafness
• acoustic trauma
• external otitis, acute otitis media
Most of these injuries can be avoided if the necessary precautions are taken before diving, and can be easily treated if they are quickly identified. Before diving for the first time, if you have to obtain technical patents or for competitions, it is strongly recommended that you visit an ENT specialist who will conduct more extensive examinations, such as the hearing test and a clinical observation of the functions of the Eustachian tube, to look for any factor that may cause these injuries.
If the function of the Eustachian tube is not good, tympanometry will assess the mobility of the eardrum. Since even a small cold can easily affect this function, eardrum must be systematically checked before entering water. There are two techniques that can be used under water, with a diving regulator in your mouth, to restore the function of the Tube: the Delonca and Frenzel maneuvers. The first consists in sliding the lower jaw forward, whereas the second in pushing the tongue forward against the upper teeth. These two maneuvers will act on the muscles of the soft palate easing the opening of the Eustachian tube. Many divers mistakenly believe that the Valsalva maneuver is the best technique, but this is not true as this maneuver forces the air to pass through the Eustachian tube in a non-physiological way.
The examination of the ear also allows to detect relative or absolute contraindications to diving. The absolute contraindications to diving are:
• perforation of the eardrum of any origin
• unilateral total deafness
• Ménière’s disease
• other diseases of the balance organ
stapes surgery with opening of the inner ear.
After ear surgery, diving can sometimes be contraindicated; each case should be discussed individually with the ENT head and neck surgeon.
Scuba diving is an exciting activity and its main goal is having fun; but to have fun in complete safety you need to undergo a health examination, take a few precautions and follow some rules.
Have a good dive!