Summer is just around the corner, and as temperatures heat up it can be a great time to get outside and enjoy activities like swimming or water sports.

While water activities can be a great way to relax or have fun, they can sometimes lead to water induced ENT issues such as swimmers ear, perforated eardrums, or barotrauma. Luckily with the right prevention many of these conditions can be avoided, and treated if needed.


Swimmers ear, or otitis externa occurs when water gets trapped in the ear canal for long periods of time. This creates a moist environment that allows bacteria or fungi to grow, resulting in infection. It is most common in the summer when humidity levels are high and with increased water exposure from activities like swimming. Swimmer’s ear can cause pain redness and swelling of the outer ear canal. Luckily there are simple ways to protect the ears to prevent swimmer’s ear from occurring.

Water protection: Wearing ear plugs or swim headbands that cover the ears help prevent water from entering the ear canal. These can be purchased over the counter or custom ear plugs can be made for you at our office.

Dry the ears: After water exposure, gently shake the head to each side to let any water drip out. You can use a tissue or towel to gently pat excess moisture from the outside of the ear canal. Avoid using Q-tips or putting anything deep inside the ear canal in an attempt to dry it. Alcohol or “swimmers ear drops” should also be avoided.

If you start to develop symptoms of otitis externa after water exposure, contact our office for an appointment. Treatment often includes medicated ear drops as well as a simple procedure to clean debris from the ear canal using suction in the office.


Hitting the water at high speeds during high intensity water activities such as wakeboarding, water skiing, and tubing can result in a hole in the eardrum, or tympanic membrane perforation.

Pain is the most common symptom of eardrum rupture after hitting the ear or side of the head on the water. You may also experience dizziness or loss of hearing on that side.

The good news is that most traumatic tympanic membrane perforations heal on their own in a couple of weeks. It is important to be seen in the office where we confirm the diagnosis and see the extent of the damage caused by the trauma. Sometimes prescription ear drops are prescribed to treat infection at that time. Rarely, the eardrum will not heal on its own and will require a graft to patch the hole.

Use caution when wakeboarding or tubing to prevent wipeouts, or wear specialty helmets for wakeboarding and protective ear plugs.


Barotrauma refers to medical conditions caused by significant shifts in air or water pressure. You may have experienced this if you have ever had ear discomfort when descending in an airplane. During a flight, when changes in air pressure occur when the plane descends, negative pressure inside the middle ear can develop and pull on the eardrum resulting in pain and/or muffled hearing. This same phenomenon can occur when diving deep underneath the water, most commonly with scuba diving.

There are 2 types of barotrauma that may occur with scuba diving:

Sinus Barotrauma: When descending while scuba diving pressure on the sinuses increases. Failure to equalize the sinuses results in negative pressure inside the sinus cavities which can cause small blood vessels inside the sinuses to burst. The first sign of sinus barotrauma is typically pain. On ascent when the negative pressure is relieved you may notice bloody discharge from the nose.

Middle Ear Barotrauma: Just like sinus barotrauma ear barotrauma occurs due to an increase in pressure while descending in the water. Divers that do not equalize the ears early or often enough will experience pain in the ears on descent. In severe circumstances, rupture of the eardrum can occur.

Barotrauma Prevention and Treatment:

Do not dive when you are congested: Refrain from diving when congested or when having pain/pressure or popping in the ears and sinuses.

Manage your allergies: Allergies cause swelling inside of the nose and at the opening of the eustachian tube and make it more difficult for the eustachian tube and sinuses to equalize. Making sure your allergies are effectively managed can reduce the likelihood of barotrauma. In addition, taking antihistamines or oral decongestants like Sudafed® 1 hour before diving can be helpful in reducing swelling inside the nose.

Take your time descending: Attempt to equalize the ears early and often when descending by gently pinching your nose and blowing with the mouth closed. If you are unable to equalize the ears or experience ear pain do not descend further until you are able to equalize middle ear pressure. Refrain from blowing hard or trying to force air into the middle ear, and if you are unable to equalize the ears, ascend to the surface.

What if I have ear problems or sinus issues after surfacing?: If you continue to have ear pain, muffled hearing, bloody noses, or pain in the sinuses for more than 24 hours after surfacing schedule an appointment to be evaluated in our office. Diagnostic testing such and an audiogram or CT scan of the sinuses as well as physical examination can help determine if any damage to the nose or ears occurred while diving. Medication is often needed to help ease pressure or fluid buildup.

Schedule an Appointment

If you think you may have any of these conditions or would like us to create custom ear plugs for you to help prevent some of these conditions, call/securely our office at 512-601-0303 to set up an appointment today.

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Posted in: Ear and Hearing Care

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