Diver Uses Nasal Spray to Clear His Ears While Underwater: Is That Smart?

Ear pain from pressure, known as middle ear barotrauma, is pretty common among divers; it's estimated that more than half of experienced divers suffer it underwater. One man found a novel way to rid himself of symptoms -- and does so while diving. Should we follow his lead?

At a recent Undersea and Hyperbaric Medical Society session, Derek Covington, a professor of anesthesiology, presented the case of a 46-year-old male diver who had started to routinely carry a nasal decongestant spray with him underwater after having difficulty with middle- ear equalization.

He was 200 feet deep during one cave dive and proceeding to the deepest point of a cave passage, at 290 feet, when he again had difficulty with middle-ear equalization. He didn't want to abort the dive, so he decided to self-administer the nasal spray underwater. This required him to remove his mask, block one nostril and carefully sniff with the other. Despite the inevitable inflow of water, he found he could replace his mask and easily equalize the problematic middle ear. The diver has subsequently followed the same procedure on other dives and reported consistent success.

But Covington doesn't recommend you follow this procedure. He stresses that this maneuver carries many risks, including disorientation, loss of buoyancy, coughing, sneezing, vocal cord spasms, and increased susceptibility to oxygen toxicity of the central nervous system. He recommends following the standard remedy: Stop your descent at the first sign of ear discomfort to allow time for equalizing, safely end the dive if you can't equalize, abstain from further diving if your ears are still feeling the pressure, and use a nasal decongestant or spray (don't put any drops in your ears).