Vertigo

Question:
A student is here again and complains about a few things. I've sent him to a good ear nose throat doctor in the city. Now this doctor said that there is nothing wrong and that he just has to equalise harder.
Now this is what happens: During decending - trouble equalizing.
After leveling of - 15 mins.into the dive he always experiences a spinning sensation, wich gets better after ascending 1 or 2 m.
During ascent from around -5m. to the surface he hears a buzzing, popping, cracking noise, pain in the ears and a small amount of blood in the mask.
Although the doctor said that there is nothing wrong,.we think that he maybe has a narrowing in one of his air canals wich connect the sinus with the ears.
Now my question is: what do you think and what can he do about it.

Answer:
The problem seems, most probably, related to a form of Alternobaric Vertigo, a form of vertigo which occurs when the two middle ear cavities are temporarily not at the same pressure, due to some disparity in the equalization on the two sides. This can equally happen during the descent or during the ascent, and it is usually transient and relatively brief in nature.
The reason is frequently a minor problem with a deviated nasal septum, some form of upper respiratory tract inflammation, excess mucus production by the nasal mucosae, and other similar conditions.
The situation should be checked again by an ENT specialist and / or a diving medicine specialist, as adequate more in depth diagnosis and treatment seems required.

Question:
Can you give me some advice? I am a diving instructor, insured though you. I have for the last 6 months a problem with vertigo in my right ear. I descend to 15-18mts and as I come up I get scared and have small vertigo. After this I get a bit scared and my body shakes. This continues until approx 10 mts when it stops.
I worked in the Maldives in '99 , there I had an emergency ascent from 28mts, after the dive I had slight numbness in my right arm , only for 2-3 mins. Afterwards I felt OK and continued to dive 2x a day. I worked in Nuweiba after this where the water was average 22 degrees centigrade, I was really scared there and I haven't been past 20 mts in these 6 months. I was also 3 months out of the water, hoping to clear it up , but it hasn't gone away.
can you offer me any solution to this problem , or who I should see. A nurse checked my ear for burst drum and found nothing wrong.

Answer:
Your problem seems, most probably, related to a form of Alternobaric Vertigo, a form of vertigo which occurs when the two middle ear cavities are temporarily not at the same pressure, due to some disparity in the equalization on the two sides. This can equally happen during the descent or during the ascent, and it is usually transient and relatively brief in nature.
The reason is frequently a minor problem with a deviated nasal septum, some form of upper respiratory tract inflammation, excess mucus production by the nasal mucosae, and other similar conditions.
The situation should be checked by an ENT specialist and / or a diving medicine specialist.
I don't think that you should worry about not being able to dive any more, however I do advise that you see a physician that you trust and may help you better identifying the nature and reason of your symptoms, including any investigation for the other possible causes of vertigo.
We have a Berlin address on your member file, but a Maldivian telephone number.
If in Germany, you could refer to our Area Director, Dr. Ulrich van Laak at germany@daneurope.org. If in the Maldives, you can refer to DAN Maldives at the Bandos Clinic and Hyperbaric Facility at clinic@bandos.com.mv and ask to be checked by one of the Diving Medical Officers. If you prefer to contact a physician in the UK, I can suggest that you contact DAN Europe UK Medical Director, Dr. John Ross, of the University of Aberdeen at j.a.ross@abdn.ac.uk.