As the diver descend without equalising faster than hydrostatic pressure can force liquids from the tissues into the middle ear, the eardrum may burst inward. The diver will feel sharp pain, followed by immediate relief as the break admits water equalising the spaces. Water from outside is generally colder than the ear air space, vertigo may happen. This may take a while but will passed by as the water get warmer by surrounding, infections usually happen afterward, it may heal but will take times.
Remember: equalise every few feet or before you feel discomfort in your ear air space.
Reverse block (reverse squeeze)
During ascent, as the water pressure decrease, our air space increase, same thing to middle ear where air fail to exit from eustachian tube, followed by outward rupture of the eardrum. At this stage, the worst thing to do is equalisation by pinching the nose(because this will add more air to the middle ear).
Remember: descent to the depth that ease the pain and slowly ascent to allowed times for the trapped air to escape(with air permitted).
Round-window rupture (oval window)
Blocking the nose and blowing forcefully ( forceful valsalva maneuvers) on the delay equalisation during descent is another common problem for inner ear. The pressure increases(during descend) together with the forceful attempt of equalising may caused the round-window rupture especially if it is executed when the eustachian tubes are congested or blocked. This rupture causes the diver's ear to feel blocked, followed by hearing ringing sound and vertigo. This is inner ear barotrauma, which may lead to permanent hearing reduction, an immediate medical attention is necessary.
Remember: Equalise your ear air space gently.
More details of Ear Barotraumas
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