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What is Sinus Barotrauma?

Chronic nasal obstruction, or a stuffy nose, is often caused by enlargement (hypertrophy) of the inferior nasal turbinates. Chronic nasal obstruction can impair normal breathing, forcing patients to breathe through the mouth and often affects their daily activities.

Enlarged turbinates and nasal congestion can also contribute to headaches and sleep disorders such as snoring and obstructive sleep apnea, as the nasal airway is the normal breathing route during sleep.

Sinus Barotrauma

What Causes Sinus Barotrauma?

Barosinusitis occurs most often in people who experience significant and abrupt changes in atmospheric pressure, such as scuba divers and flight passengers. Each sinus cavity has an orifice called an ostium, which opens into the nasal cavity and in good health will maintain an equalization of air pressure. Interference with the ostium due to blockage or inflammation of the mucosa, can in turn interfere with the equalization process.

The inflammation might be as a result of infection of the respiratory tract or of irritation due to allergic reactions. Other causes might be disease, chronic sinusitis, nasal septum deviation or other deformities. During flight descent for example, the relative negative intrasinus pressure causes an influx of fluid or hemorrhage to compensate for the rapid pressure change. A common symptom of this is pain, though other neurological manifestations might occur as a result of irritation of the frontal sinuses.

How can sinus barotrauma be remedied?

The goal in sinus barotrauma treatment is re-establishing an equalization of pressure and mitigating inflammation of the mucosa. Pain control where necessary is also another common goal. This can be achieved by the use of nasal decongestants or anti-inflammatory painkillers. Pain as a symptom can be reduced by using oral agents or pain medication where pain is extreme, however aspirin should be avoided to minimize risk of hematoma. In chronic cases where this condition or a similar case of discomfort due to sinusitis is experienced over extended periods, nasal surgery might be necessary in an attempt to enlarge the ostium and restore proper ventilation.

One should avoid using antihistamines as they dry the mucosa and exacerbate mucus production, with the exception of uncontrolled allergies, and bleeding and fluid influx creates a suitable environment for growth of bacteria, in turn worsening the infection or introducing a new infection. Antibiotics are recommended to prevent secondary infection and to catalyse the recovery process.

Mild cases of sinus barotrauma can also be proactively prevented by the use of anti-inflammatory drugs prior to future flights.

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