Feeling of Ear Congestion After Diving: Causes and Solutions - Otolaryngology

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The sensation of ear congestion after diving can be quite uncomfortable and is often attributed to several factors related to pressure changes, fluid accumulation, or inflammation. Based on your description, it seems that you experienced water entering your ear during snorkeling, followed by a persistent feeling of blockage and discomfort, despite medical evaluations and treatments.


Possible Causes
1. Eustachian Tube Dysfunction: When you dive, the pressure changes can affect the Eustachian tube, which connects the middle ear to the back of the throat. If this tube does not equalize pressure properly, it can lead to a feeling of fullness or congestion in the ear. This dysfunction can occur even without nasal congestion, as the Eustachian tube can be affected by various factors, including allergies or anatomical variations.

2. Middle Ear Inflammation: The inflammation you mentioned could be due to an infection or irritation caused by water exposure. This can lead to fluid accumulation in the middle ear, which may not be visible during a physical examination. Symptoms may include a feeling of fullness, discomfort, and sometimes even mild hearing loss.

3. Water Trapping: If water gets trapped in the ear canal, it can create a sensation of fullness. This is particularly true if the ear canal is shaped in a way that makes it difficult for water to escape. Additionally, if the water contains salt or other impurities, it could potentially irritate the ear canal, leading to increased mucus production or a feeling of stickiness.

4. Cerumen (Earwax) Issues: Although you mentioned that doctors did not find earwax, it’s worth noting that the presence of moisture can sometimes cause earwax to become impacted or sticky, leading to a sensation of blockage.

Recommended Solutions
1. Ear Drying Techniques: After exposure to water, try tilting your head to the side and gently pulling on your earlobe to help facilitate drainage. You can also use a hair dryer on a low setting held at a safe distance to help evaporate any trapped moisture.

2. Nasal Decongestants: If Eustachian tube dysfunction is suspected, over-the-counter decongestants or nasal sprays may help to relieve pressure. However, consult with a healthcare provider before using these, especially if you have any underlying health conditions.

3. Warm Compress: Applying a warm compress to the affected ear can help alleviate discomfort and may promote drainage if there is fluid buildup.

4. Avoiding Irritants: If you suspect that saltwater or other contaminants are causing irritation, avoid further exposure until the symptoms resolve.
5. Follow-Up with an ENT Specialist: Since your symptoms have persisted despite treatment, it may be beneficial to see an Ear, Nose, and Throat (ENT) specialist for a more thorough evaluation. They can perform tests such as tympanometry to assess middle ear function and determine if there is fluid present.

6. Consider Allergy Management: If you have a history of allergies, managing these may help improve Eustachian tube function and reduce inflammation.


Conclusion
The sensation of ear congestion after diving can stem from various causes, including Eustachian tube dysfunction, inflammation, or trapped water. While initial treatments may not have provided relief, it is essential to continue seeking medical advice, especially from specialists who can offer targeted interventions. In the meantime, employing ear drying techniques and managing any potential allergies may help alleviate your symptoms. If the problem persists, further diagnostic testing may be necessary to identify the underlying issue.