Characteristics and Prognostic Analysis in Diving-Induced Ear Trauma and Sudden Hearing Loss

Background/Objectives: Diving exposure can cause auditory injury involving both middle and inner ear structures. Inner ear barotrauma (IEB) and inner ear decompression sickness (IEDCS) are the major inner ear disorders and frequently present with auditory and vestibular symptoms. This study examined how diving characteristics relate to patterns of auditory trauma. Methods: A retrospective chart review of 30 patients with 36 affected ears was performed. Diving depth, clinical manifestations, and treatment responses were analyzed to identify factors influencing relatively prognosis. Results: Diving depth was the important factor associated with symptom severity and type of injury. Dives deeper than 30 meters of sea water were linked to a higher incidence of sudden sensorineural hearing loss and vertigo. In contrast, transient symptoms with minimal objective abnormalities were typically observed in shallow dives. Patients with concomitant decompression sickness (DCS) showed poorer auditory and vestibular recovery following hyperbaric oxygen therapy, while those without DCS showed better hearing improvement. Vertigo was observed in 80% of IEB cases and 66.7% of IEDCS cases. Hearing recovery was more frequently observed in cases presenting with middle ear symptoms, suggesting a relatively favorable prognosis for IEB compared with IEDCS. Conclusions: Diving depth and DCS involvement may play a role in the severity and prognosis of diving-related inner ear injury. IEB generally demonstrates better auditory outcomes than IEDCS. Further studies with larger cohorts are needed to refine prognostic indicators and optimize management strategies.