Barosinusitis, A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions

This book describes Barosinusitis, Diagnosis and Treatment and Related DiseasesThis week I had a patient who has suddenly severe headache and sneezed out blood in the yellow mucus from his nose. He had just returned from a business trip to Europe. He first sneezed out the blood on the plane bringing him back from Europe. He went to consult an ENT surgeon to examine the cause of bleeding from his nose.
An MRI of his nose showed pus discharge present in the left maxillary sinus. There was no evidence of any malignancy. He was reassured by the ENT surgeon and told that it was merely an infection that causes the bleeding. He was given a course of strong antibiotic and antihistamine. The bleeding from the nose did not stop so he decided to see me. Since nothing was given to stop bleeding, in addition to his medicine I gave him a decongestant (pseudoephedrine) which is a blood vessel constrictor.
The bleeding and headache stopped and he has improved. Barosinusitis (Aerosinusitis) is the painful inflammation or swelling of the sinuses (particularly the frontal sinuses), which may be associated with bleeding and preceded by an upper respiratory tract infection or acute exacerbation of allergies. Barosinusitis (Aerosinusitis) happens when flying in an aircraft or during deep sea diving and is due to non-equilibration or pressure differences of the internal (within the sinuses) and the external atmospheric pressure.
It can also be called Sinus BarotraumaCoexisting sinus inflammation (e.g., allergic rhinitis) raises the incidence of barosinusitis in pilots, with frequencies of up to 34% in high-performance fighter pilots and 55% in commercial pilots. Hyperbaric oxygen treatment produces up to 3% of yearly cases of barosinusitis. Sinus barotrauma is most frequent in divers, in whom the incidence of descent barotrauma is 2 times that of ascent.
Pain after a change of pressure is the most distinct symptom and is observed in up to 92% of cases. Sinus barotrauma is 2nd in incidence only to middle ear barotraumaThe frontal sinus is most often affected. These injuries happen after a rapid change in pressure, such as with flying or scuba diving. Epistaxis is a dangerous sign. Brain and orbital (eye) complications are infrequent but can happen.
Barosinusitis is not normally reported in children. Frontal sinuses are most often affected, and these do not fully develop until late adolescence. Also, children do not routinely take part in activities that lend themselves to rapid pressure changes. Underwater, diving injuries are most often the cause of barotrauma. Diving and aviation studies reveal that decompression linked with descent and higher gravity cause sinus barotrauma 2 times as often as cases related to ascent, compression, and reverse squeeze.
A medical examination will show upper respiratory tract pathology in many patients. A flow of events happens in the sinuses during changes in atmospheric pressure. Barosinusitis is often produced when sudden changes in ambient pressure are not compensated for by force equalization mechanisms within the paranasal sinuses. Headache, nose congestion and bleeding may occurThe majority of patients have complaints of a frontal distribution of pain, with ethmoidal and maxillary sinus being much less significant.
Epistaxis is the 2nd most frequent symptom and may be the single symptom in ascent cases. Nasal endoscopy and MRI of sinuses is diagnostic. The treatment is directed at the relief of pain and nasal shrinkage. Pain relief, oral/topical decongestants, nasal lavage and antibiotics are indicated for treatment. The antibiotics are preventative. Surgery can be done if medical therapy fails to relieve the painTABLE OF CONTENTIntroductionChapter 1 BarosinusitisChapter 2 CausesChapter 3 Sympto...