The Medical Consumer's Advocate

A ruptured eardrum, also known as tympanic membrane perforation:

Is scuba diving safe?

Q: About three years ago I jumped into the swimming pool and ruptured my eardrum. I have been told by a physician that I have a scar on it now. I also skydive, but it has never bothered me to go to 14,000 feet -- it actually seems to clear my ear up some. My problem is that I would really like to go scuba diving but every time I now go into a pool it takes days for all the water to drain out of my ear. Is there any advice you can give me about how to find out what is happening here and if I can go scuba diving? Needless to say, I am not willing to risk my hearing over going underwater. I would like to know what to ask for when I go to see a physician about this. I am not one who likes being given the runaround and given unnecessary tests.

A: How much do you trust your physician?

The key question is this: has the hole healed completely? Scuba diving can be very hazardous if you still have a hole in your ear drum. As you well know, as you descend in the water the ambient water pressure increases dramatically. Water under pressure can "jet" through an eardrum perforation, causing serious injury to the middle ear and inner ear. This could result in permanent deafness and severe dizziness.

What you need is an examination and/or a test. An ear, nose and throat doctor should examine your eardrum under a binocular microscope. This could reveal a small residual perforation, one that could easily have been missed by your doctor’s hand-held otoscope. A simple test called a tympanogram could also help reveal a small perforation. Given a choice, I would rely upon the microscopic examination, but it would not be unreasonably excessive to have both the microscopic examination and a tympanogram.

Let the ear, nose and throat doctor know that you want to be "cleared to go back to scuba diving." In other words, you need reassurance that the hole has healed, and that you have no other problems that would necessitate keeping the ear dry (e.g., chronic ear canal infection would be one problem that would also prevent diving).

Update 2003: I've been advised recently (by a diver) that ear plugs CANNOT be used during diving. The ear canals must remain open during the dive. I suspect that an ear plug might 'lock air' between it and the ear drum, and pressure changes during the dive can cause an eardrum perforation or worse barotrauma . . . in other words, permanent hearing loss may occur.

 

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