Outer- and Inner Ear Infections

I have had problems with both outer- and inner-ear infections. How can I prevent them from happening after a dive? 

There are ways to mitigate the risk of external ear infections (swimmer’s ear or otitis externa). Never clean your ear canal with items such as cotton swabs or other objects that might cause damage. Trauma to the external canal disrupts the protective epithelium that, along with earwax, prevents infection.

A cleansing mixture of 50 percent isopropyl alcohol and 50 percent vinegar is inexpensive and easy to use. The key is using it properly. Put two to three drops in one ear first thing in the morning. Allow it to sit in the ear for five minutes, and then repeat with the other ear. Do this procedure again at night after finishing your diving for the day. The alcohol dries the ear, and the vinegar slightly changes the pH to make it difficult for bacteria to propagate. Remember that this is a preventative measure and not a treatment. If you are ever diagnosed with otitis externa, follow your doctor’s advice, and please don’t put this solution in your ears.

The best prevention for middle-ear infections (otitis media) is using a proper equalization technique. Repeated pressure injuries (barotraumas) cause congestion, which can lead to infection if the ear is unable to drain normally. Barotrauma can be difficult to differentiate from otitis media because the ear drums can appear similar in both conditions during an otoscopic exam. It is important to tell your physician when the symptoms began.

Diving again before your symptoms are entirely gone lengthens your healing time, exacerbates the original injury and risks rupturing the tympanic membrane. You can find additional information about ears and diving on the DAN website at DAN.org/health-medicine/health-resource/dive-medical-reference-books/ears-diving.
— Lana P. Sorrell, MBA, EMT, DMT