eMedicine Specialties > Otolaryngology and Facial Plastic Surgery > Nasal & Sinus Diseases

Barosinusitis: Differential Diagnoses & Workup

Author: J Kim Thiringer, DO, Otolaryngologist, Ear, Nose, and Throat Associates
Contributor Information and Disclosures

Updated: Nov 11, 2008

Differential Diagnoses

Allergic Rhinitis
Sinusitis, Frontal, Acute, Surgical Treatment
Malignant Tumors of the Nasal Cavity
Sinusitis, Fungal
Malignant Tumors of the Sinuses
Sinusitis, Maxillary, Acute, Surgical Treatment
Nasal Polyps, Nonsurgical Treatment
Sinusitis, Maxillary, Chronic, Surgical Treatment
Nasal Polyps, Surgical Treatment
Sinusitis, Sphenoid, Acute, Surgical Treatment
Sinusitis, Acute, Medical Treatment
Turbinate Dysfunction
Sinusitis, Chronic, Medical Treatment
Sinusitis, Ethmoid, Acute, Surgical Treatment

Other Problems to Be Considered

Seasonal or perineal allergic rhinitis
Mucosal irritation from smoke or other environmental agents
Nasal polyposis
Nasal septal deviation
Concha bullosa
Infraorbital ethmoid cells
Benign or malignant sinus or nasal cavity tumors

Workup

Laboratory Studies

  • Laboratory assessment adds little to the evaluation of barosinusitis.

Imaging Studies

  • Radiologic assessment is not usually necessary to establish the diagnosis but may help to indicate location and to search for underlying causes.
  • Plain films are useful to isolate location. The usual finding is mucosal edema, which can range from slight thickening to total opacification of one or more sinuses. There may be air-fluid (ie, blood) levels. Hematoma formations, usually in the frontal sinus, are smooth and oval; they may be small or may nearly fill the sinus.
  • CT scans are considered the criterion standard for imaging assessment of barosinusitis. Obtain coronal and axial views. CT scanning accurately defines involved sinuses, extent of any hematoma, and mucosal thickening. The study can suggest predisposing factors (eg, septal deviation, middle meatus and turbinate abnormalities, nasal polyposis, underlying mass). CT scanning is an excellent tool for surgical planning.
  • MRI is similar to CT scanning in predicting involved sinuses, but it does not provide bony detail. MRI is better than CT scanning in differentiating paranasal sinus masses, although it is not as useful as CT scanning in surgical planning and can be more time consuming to obtain.

Other Tests

  • Other tests (eg, ultrasound) are not typically used to aid in diagnosis or treatment. Transillumination of the sinuses may provide some additional information on location of barotrauma, but it is unreliable and does not change treatment.

More on Barosinusitis

Overview: Barosinusitis
Differential Diagnoses & Workup: Barosinusitis
Treatment & Medication: Barosinusitis
Follow-up: Barosinusitis
References
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References

  1. 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].

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

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

  4. 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].

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

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Further Reading

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Keywords

barosinusitis, sinusitis, sinus, sinus barotrauma, sinus squeeze, sinus inflammation, paranasal sinus barotrauma, barotrauma

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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.

Medical Editor

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.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

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.

CME Editor

Christopher L Slack, MD, Otolaryngology-Facial Plastic Surgery, Private Practice, 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 unstricted gift unknown

 
 
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