Being over 40 and prone to ear troubles, I decided to have a full medical checkup (75€) before booking my next cave diving trip.
Luckily the doctor gave me the OK sign and associated paperwork after checking my hearing, blood pressure, lung function, heartbeat (electrocardiogram), throat, nose & sinuses (scan).
His advice being to put a drop or two of oil in my ears, half an hour or so before each dive, as preventive action against infections.