Diving related Injuries.ent

Diving related Injuries

Scuba diving is an activity that requires a good physical condition and a completely functional anatomy of the ear, nose and paranasal sinuses. However, most divers only start to appreciate this fact after they incur an injury to this region. Consequently, more than 50% of a diver’s emerging injuries are related to an Otolaryngologist’s area of expertise and more than 90% of these problems are related to ear morbidity.

Normally the air pressure in the ear is equilibrated to atmospheric pressure, by the Eustachian tube. In fact the Eustachian tube is normally closed and opens during swallowing, yawning or actively by using the Valsalva Maneuver.

During scuba diving the air pressure in the ear may sometimes not be equalized, therefore, leading to overpressure of the middle ear. Consequently, this will result in barotitis media (barotrauma) which is the most frequently reported injury among divers.

Common Diving-Related Injuries

The most common injuries or morbidity caused by diving are:

  • external, middle and inner ear barotrauma,
  • vertigo due to pressure or temperature,
  • facial nerve palsy,
  • divers’ inner ear disease and
  • otitis externa.

Predisposing factors for barotrauma: 

  • Common cold (runny nose)
  • Allergic rhinitis
    Anatomy of Facial Bones

    Anatomy of Facial Bones

  • Nasal polyps
  • Septal deviation


Most diving-related otological injuries can be avoided if, the prospective diver, is well prepared and undergoes a thorough clinical ENT examination. The  ENT -Neuro-otologist, of EYiasis, will assess the anatomical integrity and functionality of the paranasal sinuses and the nose. Moreover and most importantly the ENT specialist will assess the ears with special emphasis on the Eustachian tube.

At EYiasis, the ENT specialist will carry out a detailed examination, including:

  • Otoscopy,
  • Tone audiogram,
  • Assessment of the Toynbee and Valsalva test,
  • Endoscopy of the nose and nasopharynx,
  • x-ray of the paranasal sinuses and
  • Examination of the posterior labyrinth if there is a history of vertigo attacks.