EXTERNAL EAR SQUEEZE:   “Barotitis externa”

The External Auditory Canal (EAC) is occluded by cerumen, ear plugs, or wet suit hood. 
As the external pressure increases during descent the “plug” prevents the outside pressure from equalizing in the EAC. 
The EAC becomes edematous and hemorrhagic.
Pain is not relieved by Valsalva or Frenzel maneuver.

PREVENTION:   STOP THE DESCENT and ASCEND to where it is pain free.

Cortisporin Otic Solution or other steroid ear drop.

INNER EAR BAROTRAUMA:  “Barotitis interna”

A pressure differential develops between the middle and inner ears that causes an implosion or explosion of the round or oval windows that separate the inner and middle ear.

sudden onset
severe vertigo
roaring tinnitus
fullness of the affected ear
sensorineural hearing loss
does not improve with ascent

TREATMENT:  Antivertigo drugs:
meclizine (Antivert)
diazepam (Valium)
Follow-up with ENT before diving again

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