Which factor is identified as a cause of middle ear squeeze?

• A. Inability to equalize pressure
• B. Ear plugs
• C. Tight wetsuit hood
• D. Ear wax

Answer: (C)

When diving, middle ear squeeze happens because the pressure in the middle ear can’t be equalized with the surrounding water pressure during descent. The middle ear must be vented to the outside through the Eustachian tube so air can flow in and balance the pressure. If the Eustachian tube is blocked by congestion, inflammation, or swelling, you can’t open it effectively, the pressure difference increases, and the tympanic membrane is pushed inward, causing pain and possible injury.

That’s why the factor identified is the inability to equalize pressure. Ear plugs mainly seal the ear canal and don’t change middle-ear pressure, so they aren’t a direct cause. A tight wetsuit hood presses on the head externally but doesn’t create the necessary differential pressure in the middle ear. Ear wax affects the outer ear canal, not the middle-ear pressure pathway, so it isn’t a cause of middle ear squeeze.