Equalization Techniques

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The simplest methods of equalization are the yawn, swallow, jaw thrust and the head tilt. These techniques of equalizing middle ears are useful for individuals who have widely patent Eustachian tubes and never have problems with equalization. These methods hardly ever work alone without the addition of pressurization in an individual with marginally patent tubes. Pressurization techniques (see below) should ALWAYS be used first, until a diver is comfortable with a preferred technique that reliably prevents middle ear squeeze.

Table of contents:
Swallowing, yamning, jaw thrust, or head tilt
The Valsalva Maneuver
The Frenzel Maneuver
The Toynbee Maneuver
Beance Tubaire Volontaire
The Roydhouse Maneuver
The Edmonds Technique
The Lowry Technique
The Twitch

Swallowing, yawning, jaw thrust, or head tilt

The simplest methods of equalization are the yawn, swallow, jaw thrust and the head tilt. These techniques of equalizing middle ears are useful for individuals who have widely patent Eustachian tubes and never have problems with equalization. These methods hardly ever work alone without the addition of pressurization in an individual with marginally patent tubes. Pressurization techniques (see below) should ALWAYS be used first, until a diver is comfortable with a preferred technique that reliably prevents middle ear squeeze.

The Valsalva Maneuver (pressurization)

Antonio Valsalva lived in the 1700's and was the first to record a technique for pressurization of the middle ears. With the nostrils pinched closed, pressure is increased in the chest. An attempt is made to blow out the closed nostrils and cheek muscles are kept tight and retracted, not puffed out. With this technique, gradients of 6-10' of seawater can be achieved. This technique does have some disadvantages however as prolonged effort can cause venous engorgement of the tissues around the Eustachian tubes. It also causes a decrease in venous return to the heart and can lower blood pressure if the effort is prolonged. It does seem to be the easiest and most intuitive of the techniques and usually is what a diver will perform on their own with no other training.

The Frenzel Maneuver (preferred pressurization)

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