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Chapter 28 — 3
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Treatment.
The condition may be difficult to cure and treatment should be supervised by a doctor. Mild cases
may only require careful cleansing of the ear canal followed by local (topical)
antibiotic
+
steroid
ear drops three times per day. More severe cases will need pain killing tablets such as paracetamol
— two tablets four hourly as required, along with packing of the canal with special antibiotic +
steroid ointments e.g. "Kenacomb otic". Oral antibiotics may be required in severe cases. Diving,
along with further exposure to any water, should cease until the infection resolves.
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Prevention.
This can be achieved by the use of olive oil drops in the ears prior to diving, or the application of a
few drops of a solution of 5% acetic acid in 85% isopropyl alcohol in each ear after a dive to ensure
adequate drying. Commercial solutions include "AquaEar" and "Otic Domeboro". Scratching the ear
canal with matches, hair pins, cotton buds and the like, although tempting, should be avoided.
Otitis Media
(Middle ear infection")
Middle ear infection is not very common in adult divers, but may occur after
middle ear
barotrauma
or following upper respiratory tract infections (
URTIs)
or allergies. It may also follow
an uneventful dive. Most infective organisms enter the middle ear cavity via the Eustachian tubes,
which lead from the throat to the middle ear cavity, during middle ear equalisation. Occasionally a
perforation
in the ear drum will allow direct entry of contaminated water.
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Clinical features.
Clinically
there may be a constant and/or stabbing
pain
in the ear,
fever
,
ringing
noises (tinnitus)
and often a slight
hearing loss
. In this case the ear will not usually be tender to touch.
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Treatment.
Treatment
is urgent and will include oral broad spectrum antibiotics, pain relieving tablets such as
paracetamol and decongestants (such as pseudoephedrine). Ear drops are not advised. No diving or
flying in aircraft should occur until resolution — usually 5-7 days.
GENERAL INFECTIONS
There are many diseases that can be caught while diving and swimming. Some are generalised and
serious, and the organisms are especially adapted to water environments. Others, such as infectious
hepatitis, poliomyelitis, typhoid, cholera, gastro-enteritis, etc., are common diseases and are found
especially in contaminated water. Diving in contaminated water needs special clothing and
protection as well as post-dive cleansing techniques.