Middle ear barotrauma in scuba divers

Middle ear barotrauma is the most common health hazard of scuba diving. To investigate the overall incidence of middle ear barotrauma, a prospective incidence study of 51 novice divers and 46 experienced divers was conducted. Otoscopy was performed on the divers before and immediately following a single dive. The overall incidence of mild barotrauma was 40%, and the incidence of severe barotrauma was 27%. No tympanic membrane perforations were found. The most common presenting symptoms were difficulty clearing ears during descent, ear pressure, and ear pain. Barotrauma was not associated with diver age, sex, experience, otolaryngologic history, or medications. Barotrauma was associated with poor underwater visibility, difficulty clearing ears during ascent, and hearing loss after surfacing.