Sudden hearing loss scares divers

Last updated on October 5, 2024 by Divernet

November 2015, Italy. Gabriel**, an experienced Spanish diving instructor in his 40s, was traveling to Italy by car with his friends. He enjoys his first dive of the day with a rebreather. He receives Trimix (oxygen, helium and nitrogen) and carries a Petrel dive computer.

At the end of his dive he achieves a total bottom time of 95 minutes at a depth of 40 m (maximum 45 m). His dive was uneventful, but during the ascent he experienced a muffled sensation in his right ear that did not immediately disappear. This wasn’t the first time he’d experienced something similar, so he wasn’t too worried about it. He assumed that, as always, the mood would improve in the coming hours. However, 30 hours pass – with no improvement. Unfortunately, Gabriel got worse.

Two days later, he discovered that he could no longer hear in his right ear after trying to use his cell phone. He began to worry and also experienced postural dizziness. Gabriel felt miserable and wanted to go home. He decided to return to Spain the next day and seek medical treatment there.

Back in Spain, Gabriel stopped at a hospital emergency room. The doctors there believe it is ear barotrauma and recommend ibuprofen. As an experienced diver and dive instructor, Gabriel tried to explain that he believes this is not a “common” ear barotrauma. Unfortunately, the doctors only recommended that he come back the next day for a more detailed ENT examination. At this point it was already late in the evening. So he returned home.

The next morning, Gabriel decided to seek a second opinion from doctors who specialized in diving-related illnesses and hyperbaric treatment at another hospital. He wasn’t at all surprised when he received a new diagnosis – sudden deafness. The doctor explained that the sudden deafness in a diver is not a result of decompression sickness, but the result of a problem with the statoacoustic sensorineural nerve, which leads to sudden hearing loss. It is not necessarily a diving-related illness – anyone, including non-divers, can get it.

The hyperbaric doctor prescribes him 20 sessions of hyperbaric oxygen treatment (HBOT). He also explains that it cannot be treated with classic ENT treatments, but sometimes produces improvement or even complete recovery with hyperbaric oxygen therapy. Improvement will never occur just after one session of HBOT, but good results have been achieved when treatment was continued for three weeks. Sometimes there is a sudden improvement towards the middle or end of the treatment period. So they start Gabriel on HBOT.

What is Sudden Numbness?

In cases of sudden sensorineural hearing loss or sudden deafness, the statoacoustic sensorineural nerve is affected for an unknown reason and leads to rapid hearing loss – usually in one ear – either all at once or over several days. When it occurs, it is of utmost importance for patients to seek medical attention immediately. Delay in diagnosis and treatment may reduce the effectiveness of treatment results. People often notice hearing loss when they try to use the deaf ear, for example when talking on the phone. Dizziness and/or ringing in the ears (tinnitus) can be accompanying symptoms. Typically, adults between the ages of 40 and 50 are affected. About 50 percent of cases recover spontaneously, usually within one to two weeks. 85 percent of the patients treated regain some of their hearing. In about 15 percent of cases, the cause can be identified as an infectious disease, a head or brain injury, an autoimmune disease, medications that damage the sensory cells in the inner ear, circulatory disorders, a tumor on the nerve connecting the ear to the brain, or neurological diseases such as multiple sclerosis.

The disease causes complete and permanent hearing loss, impairing most life activities. Although it is a rare problem, it has been known in the diving field for many years. As already mentioned, this is not specifically an illness affecting divers. Anyone, even non-divers, can get it. However, in divers it can be triggered by changes in pressure, while in non-divers it may be triggered by another trigger.

How to treat sudden numbness

A proven and promising treatment is hyperbaric oxygen treatment (HBOT). Another common treatment in the non-diving world is the administration of corticosteroids. They reduce inflammation, reduce swelling and help the body fight disease. Steroids can be taken orally or injected into the middle ear just behind the eardrum (intratympanic corticosteroid therapy). If an actual underlying cause is discovered, additional treatment may be necessary. Infections, drug allergies, or autoimmune diseases can cause the immune system to attack the inner ear. Antibiotics or other drug treatments may be helpful.

How is sudden deafness diagnosed?

A hearing test called pure tone audiometry is the method of choice. It helps to determine whether the hearing loss is caused by sound not reaching the inner ear because something is blocking the path, or whether there is a sensorineural deficit, meaning the ear cannot process sound. The diagnosis is positive if the test shows a loss of at least 30 decibels in three connected frequencies.

If in doubt, remember that the DAN Europe medical team is always available for medical advice via the 24/7 emergency hotline.

Unfortunately, we heard from Gabriel that despite the HBOT treatment, his hearing has not yet been restored. We wish him all the best and hope that his hearing will eventually recover.

**Name changed by author