Diving with the Eyes of an Ear, Nose and Throat Specialist

In our new series of articles Dr. Gabor Kiefer, an ear, nose and throat specialist answers your questions that come up most frequently during diving, on holidays and diving tours. If you have any questions regarding the topics or other issues, feel free to comment.

Our childhood experiences often influence our adult goals and aspirations. I was around 10 years old when captain Cousteau
series started to run on TV. I decided then that I was also going to be a diver. But the little boys love of wanting to dive remained only a platonic desire for a long time and nearly 20 years had to pass before the childhood dream could become a reality.

Since then, during the following 10 years or so, I have had the chance to live through wonderful experiences and exciting adventures on numerous diving trips and safaris.
My professional work gradually included diving and more and more divers began contacting me and entrusting me with their various ear, nose and throat problems or asked me for their fit for diving tests.

In my series of articles I would like to share with you my experiences as a diver and as a doctor to make sure that your diving tours and travels are the least disturbed by ear, nose and throat problems.

Dr. Gabor Kiefer PhD.
University Assistant Professor
SOTE, Ear, Nose and Throat Clinic
Tel: +36 20 947 0701
To be continued!

Diving with the Eyes of an Ear, Nose and Throat Specialist III.

Our bodies are constantly exposed to damaging effects but the safety mechanisms of our immune system prevent the development of diseases. The
weakening of our defense system or if exposed to especially serious harming effects can lead to the formation of diseases, in our case, to the
infection of the hearing canal.
The harmful effects damaging the hearing canal can be divided into two groups: every-day effects and diving-related effects.
Besides the harmful effects at our own hands from the every-day cleaning of the ear, the hearing canal is further sensitive to drafts as well as to soaps, shampoos and shower gels which can significantly change the PH-levels of the skin or cause allergic reactions.
On a diving safari divers can dive up to four times one day and adding to this some snorkelling and fooling around in the water, divers can easily
spend up to 6-7 hours a day in water. In addition, the sea water can collect in the “S”-shaped curve, increasing the time water stays in the ear. This much time spent with water in the ears is not preferable. Just think about sitting in the bath tub for a long time when our hands wrinkle like a prune.
Plus the sea water is not sterile. The organic materials in it provide sufficient breeding ground for bacteria which can more easily enter the skin of the hearing canal soaked in water, causing infections.
The first symptom of infection in the hearing canal is the ear ache. As the process continues, the skin of the hearing canal swells, narrowing or
often completely closing the canal. From the narrowed canal there is often a discharge caused by the infection.
When the ear aches and the diagnosis is probable infection in the hearing canal, we can do the following: If on a diving safari, leave out at least one day of diving, try to gently rinse out the canal with fresh water and use anti-inflammatory ear drops 3 times a day. Once on land, consult a physician who will carefully clean out the hearing canal, prescribe ear drops or if the canal is too narrow, place an antibitoic strip into the canal.
To sum up, we can do the following to avoid all these inconveniences and to prevent infection in the hearing canal:
– Keep the hands away from the ears. Do not use cleaning sticks, hair pinsor any other objects to clean them.
– Have your ears checked by a doctor 2 weeks before a diving trip.
– Use PH-neutral or hypoallergenic hygiene products.
– Protect the ears even from the wind.
– After a day of diving, always rinse the ears with fresh water and letthe water leave the ear completely.
To be continued…

Our bodies are constantly exposed to damaging effects but the safety mechanisms of our immune system prevent the development of diseases. The weakening of our defense system or if exposed to especially serious harming effects can lead to the formation of diseases, in our case, to the infection of the hearing canal.

The harmful effects damaging the hearing canal can be divided into two groups: every-day effects and scuba diving-related effects.

Snorkeling in the Red SeaBesides the harmful effects at our own hands from the every-day cleaning of the ear, the hearing canal is further sensitive to drafts as well as to soaps, shampoos and shower gels which can significantly change the PH-levels of the skin or cause allergic reactions.

On a scuba diving safari divers can dive up to four times one day and adding to this some snorkelling and fooling around in the water, scuba divers can easily spend up to 6-7 hours a day in water. In addition, the sea water can collect in the shaped curve, increasing the time water stays in the ear. This much time spent with water in the ears is not preferable. Just think about sitting in the bath tub for a long time when our hands wrinkle like a prune.

Plus the sea water is not sterile. The organic materials in it provide sufficient breeding ground for bacteria which can more easily enter the skin of the hearing canal soaked in water, causing infections.

Ear anatomyThe first symptom of infection in the hearing canal is the ear ache. As the process continues, the skin of the hearing canal swells, narrowing or often completely closing the canal. From the narrowed canal there is often a discharge caused by the infection.

When the ear aches and the diagnosis is probable infection in the hearing canal, we can do the following: If on a scuba diving safari, leave out at least one day of diving, try to gently rinse out the canal with fresh water and use anti-inflammatory ear drops 3 times a day. Once on land, consult a physician who will carefully clean out the hearing canal, prescribe ear drops or if the canal is too narrow, place an antibitoic strip into the canal.

To sum up, we can do the following to avoid all these inconveniences and to prevent infection in the hearing canal:

– Keep the hands away from the ears. Do not use cleaning sticks, hair pinsor any other objects to clean them.

– Have your ears checked by a doctor 2 weeks before a diving trip.

– Use PH-neutral or hypoallergenic hygiene products.

– Protect the ears even from the wind.

– After a day of scuba diving, always rinse the ears with fresh water and let the water leave the ear completely.

Dr. Gabor Kiefer PhD.
University Assistant Professor
SOTE, Ear, Nose and Throat Clinic
Tel: +36 20 947 0701

Diving with the Eyes of an Ear, Nose and Throat Specialist II.

The Hearing Canal
Every diver’s nightmare is the less or more painful ear ache starting on
the second or third day of the safari which could also last for the whole
week. There are many reasons for these ear aches but most common is the
inflammation of the hearing canal. The hearing canal lies between the
outer ear and the ear drums. Its function is to get the sound waves to the
ear drums and in part, the protection of the ear drums. In an adult ear,
the surface of this “S”-shaped organ is covered with a fine layer of skin.
This skin layer contains the suet glands that produce a special substance,
the ear wax (cerumen in Latin). In normal cases, the ear wax thinly coats
the skin of the hearing canal, acting as an anti-bacterial agent and
protecting it from infections. Like with most good things, there may be a
couple of problems with ear wax: not enough or too much.
If there is not enough, the hearing canal is dry, itchy and can easily
crack, leaving room for the bacteria to reach the deeper layers of the
skin. If there is too much, it can accumulate and cause a plug, partially
or completely closing the hearing canal which may cause annoying decreased
hearing.
From all these we can quickly conclude that the use of Q-tips (ear
cleaning sticks), preferred by most people, can be the source of many
problems, so they should be used only to gently help out the ear wax that
is already on the edge of the ear canal. If we use them deeper in the ear
and we regularly clean out the ear wax, we cause the ear canal to dry out
and the skin to break. And if there is too much ear wax, we cannot clean
it all out and we simply gather it into a plug somewhere near the ear
drums.
So, it is best to leave the hearing canal alone and have it cleaned by a
doctor one or two weeks before the diving trip. The doctor will either use
a syringe filled with lukewarm water to rinse out the hearing canal or use
a gentle suction device to remove it. Of course, this will not guarantee
100% that after this procedure there is not going to be any ear infection
but the chances of it happening are decreased.
Now let us see what can actually cause an infection in the hearing canal…
To be continued…

The Hearing Canal

Every diver’s nightmare is the less or more painful ear ache starting on the second or third day of the scuba diving safari which could also last for the whole week. There are many reasons for these ear aches but most common is the inflammation of the hearing canal. The hearing canal lies between the outer ear and the ear drums. Its function is to get the sound waves to the ear drums and in part, the protection of the ear drums. In an adult ear, the surface of this “S”-shaped organ is covered with a fine layer of skin.

This skin layer contains the suet glands that produce a special substance,the ear wax (cerumen in Latin). In normal cases, the ear wax thinly coats the skin of the hearing canal, acting as an anti-bacterial agent and protecting it from infections. Like with most good things, there may be a couple of problems with ear wax: not enough or too much.

Hearing CanalIf there is not enough, the hearing canal is dry, itchy and can easily crack, leaving room for the bacteria to reach the deeper layers of the skin. If there is too much, it can accumulate and cause a plug, partially or completely closing the hearing canal which may cause annoying decreased hearing.

From all these we can quickly conclude that the use of Q-tips (earcleaning sticks), preferred by most people, can be the source of many problems, so they should be used only to gently help out the ear wax that is already on the edge of the ear canal. If we use them deeper in the ear and we regularly clean out the ear wax, we cause the ear canal to dry out and the skin to break. And if there is too much ear wax, we cannot clean it all out and we simply gather it into a plug somewhere near the ear drums.

So, it is best to leave the hearing canal alone and have it cleaned by a doctor one or two weeks before the diving trip. The doctor will either use a syringe filled with lukewarm water to rinse out the hearing canal or use a gentle suction device to remove it. Of course, this will not guarantee 100% that after this procedure there is not going to be any ear infection but the chances of it happening are decreased.

Now let us see what can actually cause an infection in the hearing canal…

To be continued…

Dr. Gabor Kiefer PhD.
University Assistant Professor
SOTE, Ear, Nose and Throat Clinic
Tel: +36 20 947 0701