Aerosinusitis: Pathophysiology, prophylaxis, and management in passengers and aircrew

Erik K. Weitzel, K. Christopher McMains, Suresh Rajapaksa, Peter John Wormald

Research output: Contribution to journalReview articlepeer-review

23 Scopus citations

Abstract

Patients presenting before flight with an upper respiratory infection are at risk for aerosinusitis. Prophylaxis of this condition consists of an oral decongestant before flight and nasal decongestant spray during the flight just prior to descent. Evaluation of the patient presenting with aerosinusitis consists of a careful physical exam with emphasis on diagnosing treatable nasal and sinus pathology. Categorization of the patient into the Weissman classification is important for determining prognostic factors for recovery. Management of this condition is based on the Weissman stage. Stage I or II lesions are generally treated conservatively with a 1-wk course of topical sprays, analgesics, a tapering course of steroids, and oral decongestants. Use of antibiotics is reserved for those cases initiated by bacterial sinusitis. Additionally, antihistamines are reserved for cases where allergies were the inciting cause. Stage III lesions are rarely seen in civilian air travelers due to the relatively low fluctuations in ambient air pressure. Aircrew that suffer Stage III aerosinusitis are at risk for recurrent sinus barotrauma that may require an expertly performed functional endoscopic sinus surgery to successfully manage it.

Original languageEnglish (US)
Pages (from-to)50-53
Number of pages4
JournalAviation Space and Environmental Medicine
Volume79
Issue number1
DOIs
StatePublished - Jan 1 2008

Keywords

  • Rhinologic barosinusitis
  • Sinus barotrauma

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

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