Hastening Drainage of Middle Ear Fluid

(Q) “Hi Doc,

I am absolutely new at diving. Went through the course and then last week-end went to Florida for my 4 check out dives. I didn’t have a cold, but my partner thought it was a good idea to take Sudafed just to make sure. I had a hard time equalizing, had to keep ascending slightly. After the first dive my ears were clogged, went down again, slightly easier to equalize, both dives weren’t more than 10 meters each.

By the next morning my ears were fine, but I took two Sudafed anyway. Dived to 20 meters, my instructor had me do the emergency ascent from 3 meters while saying ahhh, as you need that for check out, and I didn’t want to do it the day before because of my ears. My ears squeaked like crazy on the ascent. But nothing else seemed out of line no pain. Went back down and then while trying to maintain neutral buoyancy at 5 meters, accidentally inflated my BCD rather than deflated, so I shot to the surface.

After the trip three days ago, my ears are still clogged, I saw my general doctor. She says there is blood in my middle ear. She is not a dive doc, and didn’t know about diving, but couldn’t recommend it….actually thought flying was a bad idea too.

We are going to Cozumel next week. Help! I really want to dive. Is there anything I can do to speed up healing? Is seeing an ENT dive doc recommended; would it help?

Is there any hope of diving in a week? Also I started a salt water nasal douche hoping that might drag some of the gunk out of my middle ear.
Thanks, L…”

(A) Hi L….,

That’s unhappy news since SCUBA is out until a diver can equalize the ears in an entirely normal manner.

As regards hastening resolution, sadly steps the diver can take on his or her own tend to be of rather limited effectiveness.

Nasal/sinus lavage is unlikely to be of much benefit. One can try an OTC decongestant such as Sudafed??12 Hour; a heating pad applied to the affected ear; sleeping laying on the side opposite the congested ear; and frequent, gentle clearing maneuvers periodically throughout the day. But don’t expect miracles and do monitor closely for signs of infection such as fever, ear pain and dizziness.

A visit to the ENT would seem the best bet, but it’ll have to quick if one is going to Coz to dive in a week. Treatment with prescription steroids and decongestants sometimes can hasten resolution of swelling and the absorption/drainage of accumulated fluid within in the middle ear space. Mostly, however, it’s a matter of tincture of time.
New diver’s often having difficulty with clearing and the following video may prove quite useful:
The Diver’s Ear – Under Pressure


This is educational only and does not constitute or imply a doctor-patient relationship. It is not medical advice to you or any other individual, and should not be construed as such.

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4 thoughts on “Hastening Drainage of Middle Ear Fluid”

  1. I’ve been diving for over 20 years and always had trouble equalizing. The key for me is to descend slowly, don’t let the instructors/divemasters rush you. It gets easier each year. My experience with ENTs hasn’t been that great. I have pretty severe allergies, and my allergy doc is a diver. I wouldn’t bother with any doc that’s not a diver in this situation. Good luck!

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  2. Sudafed is used to treat symptoms of the common cold. The original formulation of Sudafed contains the active ingredient pseudoephedrine, but formulations without pseudoephedrine are also being sold under the Sudafed name.

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  3. This is one more example of an inexperienced diver not understanding the importance of proper training. As Doc stated, until you’ve learned to equalize properly, you’ll continue to have ear issues. And continuing to damage the ear drum and have blood buildup could lead to permanent hearing loss. A visit to an ENT and disclosure that the problem is from diving is in order. Usually the treatment is to simply not dive and wait for the problem to clear up on its own. That can sometimes take up to a month. One more sign of inexperience is not purchasing trip insurance. The Coz trip with this type of ear issue is a definite no-go.

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  4. This is why you buy trip insurance. Certainly visit an ENT doctor but delay the trip. Pushing an ear injury like that can prevent you from ever diving again.

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