Barosinusitis Clinical Presentation

  • Author: J Kim Thiringer, DO; Chief Editor: Arlen D Meyers, MD, MBA   more...
 
Updated: Nov 29, 2011
 

History

Differentiate sinus barotrauma from other causes of facial pain and headache. The history is particularly important in shortening the differential. In sinus barotrauma, a condition of barometric pressure change always exists either during or shortly after onset of symptoms.

  • With mild sinus barotrauma, the patient reports the following:
    • Mild pressure or pain over 1 or more of the sinuses that develops after return to sea level or starting point
    • Worsening congestion
    • Occasional epistaxis
  • With more severe sinus barotrauma, the patient notes the following possibly incapacitating symptoms:
    • Sudden onset of typically severe and sharp pain and pressure
    • Pain is typically in the forehead, mid face, or retro orbital.
    • Epistaxis
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Physical

Physical findings may be relatively sparse in mild cases of barosinusitis. In severe cases, the patient may have marked pain in the forehead, face, and upper teeth. This pain is typically unilateral. Erythema, edema, congested mucous membranes, epistaxis, and tenderness to palpation of the face may occur.

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Causes

The following activities and conditions place individuals at particular risk for barosinusitis:

  • Scuba and sport diving
  • Sky diving
  • Flying in military/high-performance aircraft
  • URTI or sinusitis in persons exposed to pressure changes
  • Poorly controlled allergies or anatomic abnormalities of the nose and paranasal sinuses
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Contributor Information and Disclosures
Author

J Kim Thiringer, DO  Otolaryngologist, Ear, Nose, and Throat Associates

J Kim Thiringer, DO is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery

Disclosure: Nothing to disclose.

Specialty Editor Board

Lanny Garth Close, MD  Chair, Professor, Department of Otolaryngology-Head and Neck Surgery, Columbia University College of Physicians and Surgeons

Lanny Garth Close, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, American College of Physicians, American Laryngological Association, American Society for Head and Neck Surgery, and New York Academy of Medicine

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Stephen G Batuello, MD  Consulting Staff, Colorado ENT Specialists

Stephen G Batuello, MD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery, American College of Physician Executives, American Medical Association, and Colorado Medical Society

Disclosure: Nothing to disclose.

Christopher L Slack, MD  Private Practice in Otolaryngology and Facial Plastic Surgery, Associated Coastal ENT; Medical Director, Treasure Coast Sleep Disorders

Christopher L Slack, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, and American Medical Association

Disclosure: Nothing to disclose.

Chief Editor

Arlen D Meyers, MD, MBA  Professor, Department of Otolaryngology-Head and Neck Surgery, University of Colorado School of Medicine

Arlen D Meyers, MD, MBA is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, and American Head and Neck Society

Disclosure: Covidien Corp Consulting fee Consulting; US Tobacco Corporation Unrestricted gift Unknown; Axis Three Corporation Ownership interest Consulting; Omni Biosciences Ownership interest Consulting; Sentegra Ownership interest Board membership; Syndicom Ownership interest Consulting; Oxlo Consulting; Medvoy Ownership interest Management position; Cerescan Imaging Honoraria Consulting; GYRUS ACMI Honoraria Consulting

References

  1. Sonmez G, Uzun G, Mutluoglu M, Toklu AS, Mutlu H, Ay H, et al. Paranasal sinus mucosal hypertrophy in experienced divers. Aviat Space Environ Med. Oct 2011;82(10):992-4. [Medline].

  2. Prasad BK. ENT morbidity at high altitude. J Laryngol Otol. Feb 2011;125(2):188-92. [Medline].

  3. Parsons DS, Chambers DW, Boyd EM. Long-term follow-up of aviators after functional endoscopic sinus surgery for sinus barotrauma. Aviat Space Environ Med. Nov 1997;68(11):1029-34. [Medline].

  4. Vaughan WC. Review of balloon sinuplasty. Curr Opin Otolaryngol Head Neck Surg. Feb 2008;16(1):2-9. [Medline].

  5. Hanna HH, Tarington CT. Otolaryngology in aerospace medicine. In: DeHart RL, ed. Fundamentals of Aerospace Medicine. Philadelphia: Lippincott Williams & Wilkins; 1985:520-530.

  6. Jones JS, Sheffield W, White LJ, et al. A double-blind comparison between oral pseudoephedrine and topical oxymetazoline in the prevention of barotrauma during air travel. Am J Emerg Med. May 1998;16(3):262-4. [Medline].

  7. Setliff RC 3rd. Minimally invasive sinus surgery: the rationale and the technique. Otolaryngol Clin North Am. Feb 1996;29(1):115-24. [Medline].

  8. Sonmez G, Uzun G, Mutluoglu M, Toklu AS, Mutlu H, Ay H, et al. Paranasal sinus mucosal hypertrophy in experienced divers. Aviat Space Environ Med. Oct 2011;82(10):992-4. [Medline].

 
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