From the Research
Patients with maxillary sinus tenderness and bilateral tympanic membrane (TM) retraction should avoid high-impact water sports, particularly those involving significant depth changes or pressure, such as scuba diving, deep water diving, and high-speed water skiing. These activities can worsen existing sinus and ear conditions due to pressure changes that occur underwater or during rapid acceleration and deceleration 1. The reason for these restrictions is that maxillary sinus tenderness indicates inflammation or infection in the sinuses, while TM retraction suggests negative pressure in the middle ear and possible Eustachian tube dysfunction. Water pressure changes can cause barotrauma, potentially leading to severe pain, sinus squeeze, middle ear injuries, or even rupture of the tympanic membrane.
Some key points to consider:
- Swimming is generally acceptable but should be done at shallow depths and with nose clips to prevent water from entering the nasal passages.
- Snorkeling near the surface may be tolerated by some patients but should be approached cautiously.
- Patients should wait until these conditions resolve completely before resuming high-pressure water activities, typically after medical treatment with decongestants, antihistamines, or antibiotics if infection is present, as outlined in recent medical literature 2.
- It is essential to recognize that healthy sinuses are not sterile, and the presence of certain bacteria, such as Alloiococcus otitidis, may be associated with sinusitis 3.
- The bacteriology of chronic maxillary sinusitis and the role of antibiotics in treatment have been extensively studied, emphasizing the importance of appropriate antimicrobial therapy 4, 5.