Eustachian Tube Dysfunction : Swimming Injuries

Dysfunction of the Eustachian tube (located in the centre ear) usually occurs in swimming as a result of barometric change, so divers are particularly affected. It is not a particularly common complaint of swimmers, and can affect anyone, but it must be treated if diagnosed.

What is the Eustachian Tube?

The Eustachian tube is located in the middle ear, and connects the air-full space behind the ear drum to the nose. It acts as a pressure-equalising valve, and when it is functioning properly it opens and closes with every yawn and swallow. It also acts to drain mucus produced in the central ear. When the Eustachian tube becomes blocked you experience pressure, pain and loss of hearing, and in acute cases the ear may become infected.

What Causes Eustachian Tube Dysfunction?

In swimmers, Eustachian tube dysfunction is most likely to be caused by a change in barometric pressure, but it may also be caused by a reaction to the chlorine which may cause the line of the nose to become irritable and sore, thinning the tube. Divers may be particularly prone to Eustachian tube dysfunction, because the change in pressure from air to water and from shallow to deep water can cause an effusion behind the middle ear.

How can you Prevent Eustachian Tube Dysfunction?

After diving, you may be able to prevent the effects of barotraumas by slowly breathing out air from the mouth until you reach the surface. However, this will only help partially. Nose and ear plugs may also help. If you can sense the pressure building up in your ear, you can prevent it going further by pinching your nose and blowing hard to force air through the tube. You can get a better effect by blowing up a balloon. However, you should not do this with a cold or runny nose because you may force mucus into the ear.

How is Eustachian Tube Dysfunction Treated?

It is usually treated with nasal decongestants and anti-bacterial ear drops. Beware of taking oral decongestants, as most of them are banned substances in sport. If the ear is already infected you may be prescribed antibiotics, and if your doctor suspects the condition has resulted from a chlorine allergy you may be tested and given medication for that. Should the condition become very severe, surgery may be necessary. The most common procedure is called a myringotomy. Pressure equalising tubes are not a good option for swimmers, as once these have been fitted water must be kept out of the ear.