What can cause this?
A problem on the decent?
Scuba dive sites around Gozo often have steep walls and high sided rock faces. Walls and rock faces will be used as a decent guideline down to our pre-determined depth. Here equalisation problems often occur as the pressure increases during the descent. This problem more often than not takes place in the shallow parts of the dive. We all learnt in our Open Water Course about equalisation problems and pressure related ear problems. We learnt in our course that we must ascend a few meters and try to equalise again. If this problem does not go away after a few attempts, it is better to abort the dive, correct?
What happens if you descend down the Blue Hole in Dwejra, Gozo with no problem, but equalisation issues arise at depth, say 20 meters? This situation may be caused by one of many things.
Hidden Ear Infection.
Before you depart on your diving holiday or safari, have your ears checked by your doctor. If you have a light existing ear infection before you dive it will more than likely get worse through contact with salt water. Wet, damp ears and wind is a bad combination for sore ears. With Gozo being a very small Island, the wind is often a constant factor here. If an ear infection gets worse, the inner ear and outer ear will be painful to touch. The ability to hear clearly becomes difficult, and equalisation just does not happen. A bad ear infection can completely stop you diving and your dive safari or holiday will be ruined. Severe ear infections may require a visit to the doctor and antibiotic treatment.
Some divers have increased equalisation problems when diving in cold water. The receptors often react a little quicker to cold water which makes us press harder with the equalisation procedure. This forceful method can lead to a slight swelling of the soft tissues and force fluids and blood into the middle ear which will lead to slight hearing impairment. During the summer months on Gozo, it is very warm and the water temperature is around 27 – 28 degrees. Many of the divers still dive with a hood all year round for ear protection and warmth. In the winter time, it can drop down to 11 degrees so diving with a hood is a must. If you have a cold water problem, it is better to wear a correctly fitting hood – more to this later.
Tooth Decay or Toothache?
Tooth decay and toothache can cause problems with equalisation. If inflammation is present around the defected tooth, this can quickly spread into the ear canal. Cold water will not help and may make things worse. Tooth fillings may also cause pain on the ascent when expanding air under the filling tries to escape. Often the expanding air cannot escape, and it will push the filling out completely. Inflammation and swelling can easily lead to the ears and Eustachian tubes, causing ear pain on decent. Tooth problems and dentist appointments must be met before you start out on your diving trip. If not, the consequences maybe toothache, a lost filling or you are unable to equalise.
An Ill-fitting Hood?
Sometimes the decent goes without a problem and the scuba hood-moulds onto your head and around your ears like a glove. On the descent, the hood closes tight around your ears and causes a vacuum. From the middle ear, we get less pressure against the eardrum than the surrounding pressure in outer-ear. This can lead to a squeeze which will cause internal bruising and possible blood in the ear. Sometimes hoods which contain trapped air prevent equalisation methods happening. This can lead to a ruptured eardrum or a reverse block, depending on the circumstances. A ruptured eardrum is often a quick sharp pricking pain, then it disappears. Water will enter the inner ear and possibly cause vertigo or loss of balance. After arriving at the surface, you will often find blood in the outer ear. An eardrum rupture must be medically treated and examined thoroughly before re-entering the water.
Descend slowly on your dives and equalise early and often. Make sure your scuba hood fits you correctly and is not too tight. If you get a vacuum inside your hood, pierce the outside with a hot knitting needle. This will help you equalise easier and it will stop the hood filling with air. Some hoods come with pre-manufactured holes in them, buts sometimes they are very small. It might be necessary just to make the holes is a little larger. This prevents a vacuum building inside the hood as well, which will help with equalisation.