The Ears & Diving
Ear related problems from pressure while diving is one of the most common problems faced by divers. Read on as experts from DAN Asia Pacific fill you in on the ins and outs of ear ailments and how to prevent them (Text by DAN Asia Pacific, photos by Stephen Frink)
ANATOMY OF AN EAR
The ear is the organ of hearing and balance. Understanding its anatomy can help better illustrate why it’s essential to equalise. The ear consists of three distinct spaces filled with either air or liquid: the external, middle and inner ear.
As divers descend in the column of water, environmental pressure on the body increases in a linear fashion across the body.
To prevent pressure-related injuries such as bleeding, 0edema (swelling) of soft tissues, leakage of fluid into the air space and membrane rupture, divers must actively enable air from the throat to enter through the eustachian tubes into the middle ear by using equalisation techniques.
Why You Must Equalise
AT 1 METRE
The water pressure outside of your eardrums is 10 percent greater than the pressure in your middle ears. Your eardrums flex inward to compensate – you may feel some pressure
AT 2 METRES
The pressure differential is 20 percent greater than at the surface and your eardrums bulge further. You feel definite pressure, and many begin to feel pain
BEYOND 2 METRES
Your eardrums are stretched to their limits. Unless you have equalised, you will feel significant discomfort or pain. The tissues and blood vessels in your ear may start to break, and as the pressure differential builds, your eustachian tubes will shut, making equalisation impossible
AT 3 METRES
If your eardrums haven’t broken yet, the pressure differential begins to draw blood and fluid from the surrounding tissues into your middle ears, causing middle-ear barotrauma. Pain may become a feeling of fullness which will remain for a week or more
BEYOND 3 METRES
If you haven’t equalised, your eardrum can break and cause water to flood your middle ears. The sudden exposure can cause vertigo
HOW TO EQUALISE
There are several techniques divers can employ to effectively equalise their ears.
- PASSIVE
Requires no effort. Occurs during ascent - VOLUNTARY TUBAL OPENING
Try yawning or jaw wiggling - VALSALVA MANOEUVRE
Pinch your nostrils and gently blow through your nose - TOYNBEE MANOEUVRE
Pinch your nostrils and swallow (good technique, if equalisation is needed during ascent) - FRENZEL MANOEUVRE
Pinch your nostrils while contracting your throat muscles and make the sound of the letter “k” - LOWRY TECHNIQUE
Pinch your nostrils and gently try to blow air out of your nose while swallowing (think Valsalva manoeuvre meets the Toynbee manoeuvre) - EDMONDS TECHNIQUE
Push your jaw forward and employ the Valsalva manoeuvre or the Frenzel manoeuvre
PRACTICE MAKES PERFECT
Divers who experience difficulty equalising may find it helpful to master several techniques. Many are difficult until practised repeatedly, but this is one scuba skill you can practise anywhere – in a pool, on a plane or even at your desk. Just do it gently!
For the rest of this article and other stories from this issue, see Scuba Diver No.113 Issue 3/2018