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Sinus Barotrauma


Presentation

  • It is noted that although symptoms were predominantly frontal, x-ray changes were most often present in the maxillary sinuses.[ncbi.nlm.nih.gov]
  • Emergency physicians should strongly consider a diagnosis of sinus barotrauma in patients who present with symptoms of sinusitis and a history of recent flight.[ncbi.nlm.nih.gov]
  • Abstract We report a case of a diver who suffered an episode of maxillary sinus barotrauma that presented with decreased sensation over the cutaneous distribution of the infraorbital nerve after an ascent which produced facial pain and crepitus.[ncbi.nlm.nih.gov]
  • We present two severe cases where delayed diagnosis caused significant morbidity.[ncbi.nlm.nih.gov]
  • The presentation and outcome of 39 patients with recurrent sinus barotrauma managed by FESS have been reviewed. Ninety-five per cent were able to resume their full flying duties without further treatment or recurrence of sinus barotrauma.[ncbi.nlm.nih.gov]
Jugular Venous Distention
  • There is frequently jugular venous distention with associated decreased cardiac output and hypotension. There is marked tachypnea or shortness of breath with shallow respiration.[divinghbo.com]
Blurred Vision
  • The patient reported severe sudden onset blurred vision in the right eye associated with a mild headache and epistaxis on surfacing from diving. The patient had her first medical review the day after returning from her trip.[ncbi.nlm.nih.gov]
Cranial Nerve Involvement
  • Existing reports of a similar nature are reviewed and the pathogenesis of cranial nerve involvement in barotrauma is discussed. Guidelines for treatment are suggested.[ncbi.nlm.nih.gov]
  • Maxillary sinus barotrauma with fifth cranial nerve involvement. J Laryngol Otol 1991; 105:217–219. 7.
Campbell PA. Aerosinusitis: its causes, course and treatment. Ann Otol 1944; 53:291–301. 8.
Flottes L.[nasodren.com]
  • Murrison AW, Smith DJ, Francis TJ, Counter RT (1991) Maxillary sinus barotrauma with fifth cranial nerve involvement. J Laryngol Otol 105(3):217–219 PubMed CrossRef Google Scholar 21.[link.springer.com]

Treatment

  • Before treatment, divers who required surgery reported significantly more symptoms than divers who were treated conservatively. Post treatment there were no significant differences between the medical and surgical group.[ncbi.nlm.nih.gov]
  • The pathophysiology and treatment of frontal sinus barotrauma are reviewed. Emergency physicians should strongly consider a diagnosis of sinus barotrauma in patients who present with symptoms of sinusitis and a history of recent flight.[ncbi.nlm.nih.gov]
  • Abstract Sinus barotrauma is usually easy to diagnose, and treatment achieves good results. We present two severe cases where delayed diagnosis caused significant morbidity.[ncbi.nlm.nih.gov]
  • Ninety-five per cent were able to resume their full flying duties without further treatment or recurrence of sinus barotrauma. Passing a postoperative decompression testing is a reliable indicator of an aviators's fitness to fly after FESS.[ncbi.nlm.nih.gov]
  • Complications of this treatment are uncommon and the aviator has usually been able to resume full flying duties after undergoing a decompression test.[ncbi.nlm.nih.gov]

Prognosis

  • Prognosis All but the acute invasive form carry a good prognosis once the diagnosis is made and treatment completed. Fulminant fungal sinusitis is associated with a 50% mortality rate, even with aggressive surgical and medical treatment.[patient.info]
  • Outlook (Prognosis) Barotrauma is usually noncancerous ( benign ) and responds to self-care. Hearing loss is almost always temporary. When to Contact a Medical Professional Try home care measures first.[mountsinai.org]

Etiology

  • This case illustrates a potential confusion between a decompression sickness etiology and a barotraumatic etiology for the observed sensory deficit.[ncbi.nlm.nih.gov]
  • Acute sinusitis is usually initiated by an acute respiratory tract infection of viral etiology. 急性鼻窦炎常常是由病毒性病因的急性呼吸道感染而发生。[hujiang.com]
  • On the other hand, the problem may remain undiagnosed when the history fails to relate the symptoms to exposure to environmental pressure changes or if the focus is on other etiologies.[medigoo.com]
  • […] diagnosed when presented to physicians immediately after exposure. [2] [3] On the other hand, the problem may remain undiagnosed when the history fails to relate the symptoms to exposure to environmental pressure changes or if the focus is on other etiologies[en.wikipedia.org]

Epidemiology

  • Epidemiology Although this is less common than acute sinusitis, it remains a reasonably common entity in itself, accounting for about 25 cases per 10,000 person-years in an average UK GP practice [ 2 ].[patient.info]
Sex distribution
Age distribution

Pathophysiology

  • The pathophysiology and treatment of frontal sinus barotrauma are reviewed. Emergency physicians should strongly consider a diagnosis of sinus barotrauma in patients who present with symptoms of sinusitis and a history of recent flight.[ncbi.nlm.nih.gov]
  • Therefore, information is provided, e.g. on anatomical and pathophysiological features. Divers and physicians should have in mind that occasional headache during or after diving sometimes signals serious neurological disorders like vision loss.[ncbi.nlm.nih.gov]
  • Otology 464 Downloads 28 Citations Abstract The pathophysiology, differential diagnosis, and currently available management of barotrauma affecting the ears and sinuses after scuba diving are reviewed, along with medical standards for resuming scuba diving[link.springer.com]
  • Related Articles Update on Middle Ear Barotrauma after Hyperbaric Oxygen Therapy--Insights on Pathophysiology.[connection.ebscohost.com]
  • Aerosinusitis: pathophysiology, prophylaxis, and management in passengers and aircrew.[verywellhealth.com]

Prevention

  • Prevention There are a number of measures that you should be familiar with in order to prevent the condition including refraining from diving or travelling by plane when having an infection involving the upper respiratory tract or even severe congestion[firstaidcprmississauga.ca]
  • Prevention Obviously, it's best to be aware of the potential for barotrauma and avoid it all together, if possible.[verywellhealth.com]
  • Prevention To prevent yourself from experiencing an uncomfortable vacation this summer try taking precautions before you travel to your favorite vacation spot.[share.upmc.com]

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