Barosinusitis Workup

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

Laboratory Studies

  • Laboratory assessment adds little to the evaluation of barosinusitis.
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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.
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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.
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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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