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- [Aerosinusitis : Part 2: Diagnosis, therapy and recommencement of flight duties.] [JOURNAL ARTICLE]
- HNO 2014 Mar 15.
Aerosinusitis more frequently affects the frontal sinus than the maxillary sinus and mostly occurs during descent. Sinonasal diseases and anatomic variations leading to obstruction of paranasal sinus ventilation favor the development of aerosinusitis. This Continuing Medical Education (CME) article is based on selective literature searches of the PubMed database (search terms: "aerosinusitis", "barosinusitis", "barotrauma" AND "sinus", "barotrauma" AND "sinusitis", "sinusitis" AND "flying" OR "aviator"). Additionally, currently available monographs and further articles that could be identified based on the publication reviews were also included. In part 2, diagnostic measures, drug therapy, balloon dilatation and endoscopic sinus surgery are presented, along with a discussion regarding when flight attendants and pilots are able to resume their work. Endoscopic surgery to expand the natural drainage pathways of the affected sinuses with minimal surgical trauma to the healthy mucous membranes is largely successful.
- [Aerosinusitis: part 1: Fundamentals, pathophysiology and prophylaxis]. [English Abstract, Journal Article]
- HNO 2014 Jan; 62(1):57-64; quiz 65-6.
The relevance of aerosinusitis stems from the high number of flight passengers and the impaired fitness for work of the flight personnel. The frontal sinus is more frequently affected than the maxillary sinus and the condition generally occurs during descent. Sinonasal diseases and anatomic variations leading to obstruction of paranasal sinus ventilation favor the development of aerosinusitis. This Continuing Medical Education (CME) article is based on selective literature searches of the PubMed database (search terms: "aerosinusitis", "barosinusitis", "barotrauma" AND "sinus", "barotrauma" AND "sinusitis", "sinusitis" AND "flying" OR "aviator"). Additionally, currently available monographs and further articles that could be identified based on the publication reviews were also included. Part 1 presents the pathophysiology, symptoms, risk factors, epidemiology and prophylaxis of aerosinusitis. In part 2, diagnosis, conservative and surgical treatment will be discussed.
- Comprehensive surgical management of the aerosinusitis patient. [Journal Article, Review]
- Curr Opin Otolaryngol Head Neck Surg 2009 Feb; 17(1):11-7.
Provide a comprehensive overview of the pathophysiology and surgical management strategies of sinus barotrauma with attention to recent advancements in endoscopic surgical technique.New endoscopic frontal sinus surgery techniques have been shown to be highly effective with rhinosinusitis management, but these techniques have not been evaluated with sinus barotrauma management.We discuss the surgical goals and expectations with sinus barotrauma and contrast these to those with chronic rhinosinusitis (CRS). Sinus barotrauma surgery requires anatomic patency of involved sinuses whereas CRS patients are satisfied with a lack of symptoms from any residual mucosal disease.
- Aerosinusitis: pathophysiology, prophylaxis, and management in passengers and aircrew. [Journal Article, Review]
- Aviat Space Environ Med 2008 Jan; 79(1):50-3.
Patients presenting before flight with an upper respiratory infection are at risk for aerosinusitis. Prophylaxis of this condition consists of an oral decongestant before flight and nasal decongestant spray during the flight just prior to descent. Evaluation of the patient presenting with aerosinusitis consists of a careful physical exam with emphasis on diagnosing treatable nasal and sinus pathology. Categorization of the patient into the Weissman classification is important for determining prognostic factors for recovery. Management of this condition is based on the Weissman stage. Stage I or II lesions are generally treated conservatively with a 1-wk course of topical sprays, analgesics, a tapering course of steroids, and oral decongestants. Use of antibiotics is reserved for those cases initiated by bacterial sinusitis. Additionally, antihistamines are reserved for cases where allergies were the inciting cause. Stage III lesions are rarely seen in civilian air travelers due to the relatively low fluctuations in ambient air pressure. Aircrew that suffer Stage III aerosinusitis are at risk for recurrent sinus barotrauma that may require an expertly performed functional endoscopic sinus surgery to successfully manage it.
- [Aviation medicine problems in otorhinolaryngology]. [English Abstract, Journal Article]
- Z Arztl Fortbild Qualitatssich 1999 Oct; 93(7):509-12.
The physico-technical conditions during flight change the physiology of the paranasal sinus, of the middle ear and of the teeth especially due to decompression. Clinical problems and the possibility of prophylaxis and therapy before and under flying conditions are declared. Aerosinusitis, -otitis and aerodontalgia are discussed. The hearing system under conditions of aircraft noise, noise protection for passengers and pilots are explained as some advises for flying with implanted hearing aids. The kinetosis as a disturbed physiological process connected with the kinetic stimulus of flying, the influence of their origin and their strengthening or prevention are described.
- Medical barofunction testing of aviators with otorhinolaryngologic disease. [Journal Article]
- Aviat Space Environ Med 1979 Oct; 50(10):1062-6.
Forty aviators with otorhinolaryngologic pathology, previously considered physically disqualified for flight status, were tested in the hypobaric chamber to evaluate tolerance to rapid barometric pressure changes. Testing consisted of three sequential trials in the low-pressure chamber (LPC) at rates of 1,524 m, the second to 3,048 m, and the third to 5,486 m. Failure consisted of any symptoms (pain) or physical findings of barotrauma (aerosinusitis or aerootitis media). Results revealed a 22.5% failure rate. The findings indicate this type of "Medical Barofunction Test" is a practical adjunct to the clinical evaluation of the aviator. The profile is safe and free from serious dysbaric episodes experienced above 7.620 m. Follow-up studies revealed the incidence of false negatives to be only 8% by the LPC test. The findings are not significantly different from the medical disqualification rate of a normal student aviator comparison group.
- [Aerosinusitis (author's transl)]. [Case Reports, English Abstract, Journal Article]
- Arch Otorhinolaryngol 1976 Nov 15; 214(2):167-73.
After distinguishing a nonobstructive from an obstructive form of aerosinusitis, different pathological changes are discussed. Two cases illustrate the possibility of endoscopic removal of submucous sinus hematomas. Nonobstructive aerosinusitis may be due to highly viscous paranasal secretion. In obstructive sinus disease intranasal application of vasoconstrictors may prevent additional aerosinusitis. In 71 patients with obstructive frontal and maxillary sinusitis, aerosinusitis followed a negative sinus pressure of 66 mm Hg and 35 mm Hg respectively. Intranasal application of a vasoconstrictive and antiexsudative solution for prophylaxis of aerosinusitis lead to an increase of negative pressure tolerance of 47-57 mm Hg.
- Treatment of aerotitis and aerosinusitis with topical DMSO. [Journal Article]
- Aerosp Med 1967 Jun; 38(6):629-30.
- [Aerosinusitis]. [Journal Article]
- Fulorrgegegyogyaszat 1960 Sep.:116-9.
- Aerotitis media and aerosinusitis in submarine trainees: a prophylactic study. [Journal Article]
- U S Armed Forces Med J 1957 Nov; 8(11):1571-6.