Barotrauma – an underwater condition

Barotrauma – an underwater conditionFabulous coral reefs, shoals of exotic fish shimmering with colours, mysterious sunken shipwrecks… Aren’t you tempted to see this underwater world? Be careful: if you have a deflected nasal septum or sinus troubles, think twice before you decide to go even a few metres underwater. You had better check if your health will allow you to go diving first.

Nasal congestion equals troubles

Most of us do not have a nose divided into two perfectly symmetrical parts by the septum. This is completely normal and usually doesn’t cause bigger health issues. ‘Problems only start when the deviation is severe. It disturbs the patency of the nose and may lead to breathing problems, snoring, sleep apnoea, recurring rhinitis, or inflammatory conditions in the ears’. A deviated nasal septum can also cause abnormal functioning of the paranasal sinuses, although we should remember that such problems can also be caused by completely different factors. This could be anything from enlarged tonsils, to allergies, to upper respiratory tract infections that have not been completely treated. As a result, we have to deal not only with bothersome rhinitis and the feeling of nasal congestion, but also headaches, coughing, morning hoarseness, and bad breath. Obstruction of the nose for various reasons can also significantly complicate the life of underwater world lovers.

The big blue with obstacles

Diving means being subjected to large pressure changes that can influence our organisms. If we suffer from nasal septum deviation, sinusitis, or we are dealing with another health issue that causes obstruction of the tubes connecting the sinuses with the nasal cavity, the lack of normal ventilation hinders free ear clearing and spontaneous equalising. ‘This may lead to so-called barotrauma, which is a physical tissue injury that most often affects the middle ear, and less frequently the sinuses. Trauma of this nature may occur both during submerging and surfacing and ultimately even lead to sinus damage or hearing problems. Therefore, if we notice alarming symptoms, we should visit a doctor immediately’. In research conducted by DAN Europe among divers, almost one third admitted to have experienced at least one episode of ear or sinus barotrauma. It is also worth noting that diving is not the only circumstance in which this kind of trauma caused by pressure can occur. It also happens to people travelling by plane.

Cure before you dive

Do nose or ear ventilation problems mean that you have to give up diving forever? Fortunately not, but it is necessary to get treatment before going on an underwater adventure. To do so, you need to consult a laryngologist. In the case of paranasal sinusitis, antibiotic therapy is usually necessary, as well as refraining from pursuing your underwater hobby until the treatment is finished. If taking antibiotics does not have any results or the inflammation is chronic, doctors can also apply other methods, such as irrigation of the sinuses with a normal saline solution under pressure with the use of a special device, a hydrodebrider. This allows the remaining secretions to be removed and proper ventilation to be restored. ‘In the case of a deviated nasal septum, the only treatment is surgery: septoplasty. This sounds serious, but thanks to today’s minimally invasive methods and the fact that the whole procedure is usually performed intranasally, patients are often discharged after just one day with no external dressings and can look forward to a quick recovery’.


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