OBJECTIVES: Much controversy exists concerning the risk of inner ear barotr
auma after stapes surgery in scuba and sky divers. Uniform consensus has no
t been established regarding poststapedectomy barorestrictions. The purpose
of this study was (1) to determine the prevalence of adverse auditory and/
or vestibular sequelae in patients after stapedectomy related to scuba and
sky diving, and (2) to offer recommendations on barometric exposure after s
tapes surgery.
STUDY DESIGN: Survey questionnaires were mailed to 2222 patients who had un
dergone stapedectomies at a single tertiary otologic referral center betwee
n 1987 and 1998. Two hundred eight of the initial 917 respondents (22.7%) h
ad snorkeled, scuba, or sky dived after stapes surgery, and 140 of these re
sponded to a second questionnaire detailing dive protocols, otologic sympto
ms, and their relationship to the diving activities. Of the 140, 28 had scu
ba or sky dived. Their survey data were analyzed and their medical records
were reviewed.
RESULTS: Four of the 22 scuba divers (18.1%) experienced otologic symptoms
at the time of diving. These included otalgia on descent (3/22; 13.6%), tin
nitus (1/22; 4.5%), and transient vertigo on initial submersion (1/22; 4.5%
). One patient had sudden sensorineural hearing loss and vertigo develop 3
months after scuba diving, which he related to noise exposure. He was subse
quently found to have a perilymph fistula, which was successfully repaired.
Of the 9 patients who sky dived, 2 patients (22.2%) reported otologic symp
toms during the dive. No significant diving-related long-term effects indic
ative of labyrinthine injury were seen in any of the 28 patients.
CONCLUSIONS: Stapedectomy does not appear to increase the risk of inner ear
barotrauma in scuba and sky divers. These activities may be pursued with r
elative safety after stapes surgery, provided adequate eustachian tube func
tion has been established.