![]() ![]() For a leisure activity, diving puts the auditory system at the risk of a wide variety of complaints. Since then it has become a popular hobby, with increasing access to SCUBA diving while on holiday. ![]() Pre-1970s, diving was seen as a predominantly male working occupation. There is a need for a prospective data registry and controlled trials to better evaluate diagnostic and treatment algorithms. It may be possible for divers to return to subaquatic activity after stakeholder risk acceptance and informed consent, provided: (1) sensorineural hearing loss is stable and not severe (2) there is no vestibular involvement (via ENG) (3) high-resolution computed tomography has excluded anatomical predilection to IEBt and (4) education on equalising techniques is provided. Steroids are used, but without high-level evidence. Exploratory surgery is indicated for severe or persisting vestibular symptoms or hearing loss, deterioration of symptoms, or lack of improvement over 10 days indicating significant pathology. Recompression does not appear to cause harm if the diagnosis (IEBt vs IEDCS) is doubtful (limited case data). Once diagnosed, conservative management is the recommended first line therapy for IEBt. IEBt in divers may be difficult to distinguish from inner ear decompression sickness (IEDCS), and requires dive-risk stratification and careful interrogation regarding diving-related ear events, clinical assessment, pure tone audiometry, a fistula test and electronystagmography (ENG). Twenty-five case series (majority surgical) provided guidance on diagnostic pathways nine solely reported divers. Sixty-nine papers/texts were identified and 54 accessed. Following a literature search, the pathophysiology, diagnosis, and treatment of IEBt in divers and best-practice recommendations for returning to diving were reviewed. IEBt includes perilymph fistula, intralabyrinthine membrane tear, inner ear haemorrhage and other rarer pathologies. Be sure to also keep your hands clean and avoid people who are ill to slow the spread of infection.Inner ear barotrauma (IEBt) constitutes a spectrum of pressure-related pathology in the inner ear, with antecedent middle ear barotrauma (MEBt) common. To help prevent ear barotrauma from ear infections and other illnesses, keep your ears clean and dry. Diving again before you’ve fully recovered could lead to further injury. If you have recently experienced ear barotrauma, be sure to stay on dry land until your ears have fully recovered. Ignoring this warning sign could leave your ears injured more permanently. If you start to feel pain while diving, make your way back to the surface slowly. If you plan to go scuba diving, it can be a good idea to not only equalise your ears before you hop in the water and as you descend, but to also head into the water feet first. ![]() When travelling by plane, try to also stay awake throughout the take-off and landing. To help reduce your chances of experiencing ear barotrauma, you might consider using earplugs designed for air travel, which may help to slow the effects of pressure changes, or taking decongestants or antihistamines before you fly. It’s normal to experience ear barotrauma occasionally, especially when you’re travelling, but recurring and severe cases are best avoided where possible. ![]()
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