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Scuba diving and ENT diseases

Diver who is reporting to the mate of their difficulties in compensation of middle ear ’

Person engaged in sports and in particular diving and apnea is more exposed to a number of issues of jurisdiction ORL.
See them with order considering what caused, How to prevent them and how to cure them.







Diagram showing the outer and middle ear Anatomy of ’ and ’ of the eustachian tube (in green)

Ear infections
Ear infections are a huge problem for divers but c ’ é otitis and otitis, their correct identification is essential for proper therapeutic setting.
Hold long ears immersed in water promotes the maceration of the skin and reduces the protective capacity of earwax: You can have infections involving only the ’ outer ear (otitis externa). This type of ear infection is characterized by a mild pain with feeling of ovattamento ’ and discharge of pus from the ear headset (otorrhea). The therapy is carried out with disinfectants and antibiotics in the form of ear drops. Only rarely are necessary treatments for mouth.
The ears are also exposed to other types of diseases related to high blood pressure. L ’ the middle ear is a region of limited size (big as a gaming nut) but very delicate, Home of auditory ossicles, full d ’ air (about 1cc) completely separate from the external ear canal from the tympanic membrane and in communication with the Airways due to Eustachian tube tube.
The eustachian tube is a pipe normally collapsed that is opened by certain muscles normally triggered by swallowing.
It is important for those who make sports divers have well understood that l ’ the middle ear is always isolated from the external ear and ’, most of the time, also from the Airways.
When you dive, regardless of whether scuba diving or, l ’ water makes a lot of pressure on the body. This pressure is able to compress the chest increases the pressure of the air inside ’ and therefore also in the upper airways. Also from the ’ water pressure compresses the tympanic membrane, introflettendola. Its elasticity is limited and after a few meters diving starts to hurt. It is therefore essential to get more in depth increase the amount and pressure of air in the middle ear ’ ’ opening the tuba compensation techniques.

Diagram showing the relationship between the middle ear, Eustachian tube and nasopharynx

If these are not effective ’ water pressure can be such a break through the eardrum causing a Barotraumatic perforation of the tympanic membrane.
When the eardrum will pit, the pain is reduced suddenly.
The same problem may also occur during the ascent when the ’ air that expands in ’ middle ear fails to move in.
The drilling can close spontaneously, If this does not happen you have to proceed with surgery (myringoplasty).
Repeated maneuvers of compensation, especially if not done correctly or if your nose is not in perfect working order, can ignite the tuba by closing. Problems arise then after the dive ’: l ’ ’ trapped air in the middle ear tends to be absorbed by the mucous membranes and this creates a negative pressure that tends to completely bend inwards the tympanic membrane by reducing l ’ excursion and giving the feeling of ovattamento. Then the negative pressure sucks in mucosal fluids accentuating the feeling of ovattamento and “ear full”. Is referred to as effusive otitis media characterized by hearing loss with a nuisance without real pain.
The mucus that ristagnagna can promote bacterial superinfection and in this case the pus accumulates due to strong pressure on the eardrum with very intense pain (acute otitis media). L ’ infection also causes hearing loss, stunning, malaise and fever often.
In the first phase it is important to promote the reopening of the eustachian tube using cortisone drugs (strong Ant-edema) either by mouth or by nasal sprays. In the case of a sovrainfezioe it is necessary to set an antibiotic therapy.

In face the rooms normally filled d ’ air: paranasal sinuses (maxillary sinuses, front panels, sphenoid sinuses and sphenoid cells). Such structures are communicating with the nasal cavity through small openings (OSTI). In healthy subjects, when diving, the pressure inside them easily manages to balance with that of the upper airways without special manoeuvres. In pathological cases (turbinate hypertrophy, rhinitis, rhinosinusitis with or without polyps) hosts can be blocked and the ’ air may remain trapped in the sinuses causing the pain.
Also l cylinder air humidified not ’, sudden changes in temperature and pressure can encourage infectious/inflammatory processes which may in turn cause sinusitis.
In case of inflammatory processes of the nose you can have a ’ mucosal inflammation of the nasopharynx (where lead the auditory tube tube) and so it is more prone to ear problems.
Sinusitis are treated with steroid medications for both mouth spray and often with antibiotic therapy.

Who does a very unpleasant form underwater can be subject and intense Vertigo.
L ’ sea water has a temperature of several degrees lower than that of the body. If the ears are set at a temperature much different between them you can trigger a very very intense Vertigo, giving the impression that the world is turning around, Luckily-limiting and lasting a few seconds, almost always less than a minute.
This particular condition can occur if an abnormal shape of the external ear canal (conducted close, osteomas, Exostoses) pinching of ’ air ’ ’ water temperature from the ear Island l. When, moving, l ’ air can get out is replaced by cold water which lowers the temperature of ’ ear suddenly causing dizziness.
A ’ another possible cause may be the presence of ear wax that slows down the passage of ’ cold water in one ear but not in ’ more.
If you experience this very nasty event it is important to keep your eyes open looking for a visual reference (the light, a companion) What if you could cling to a rock. It is essential to try to keep l ’ constant weight and not to move: the dizzying crisis may be such as not to distinguish up from down and if you too can arise from drunkenness ’ l depth deepens with dramatic consequences.
Thankfully the crisis resolves spontaneously within one minute. This event can be confused with a panic attack.

Pharyngitis- laryngitis
L ’ air you breathe from the cylinder is not humidified and tends to dry out the mucous membranes of the throat exposing them to laryngitis (dysphonia) and pharyngitis.

As we have seen, most problems related to diving is in the ears that the sinuses are tied to an optimum ability to not air the nose, sinuses and compensate. It is therefore essential to consider that there are no predisposing conditions rhinitis (turbinate hypertrophy, septal deviation, familial) and keep healthy their nose with the nasal wash as a habit.
In case there is also a slight nasal obstruction (cold) It is advisable to suspend dives.
It is also important to exclude the presence of earwax plugs before diving.
Remember that therapy of otitis and sinusitis due to diving is a bit’ different from that of the same diseases not related to pressure and is almost always necessary even a treatment disinfiammare and deflate cortisone necessary for mucous.