Sinus barotrauma

Introduction Sinus pressure injury is the damage suffered by the sinus mucosa when the air pressure in the sinus cannot be changed following the drastic change of the external air pressure. More common in flight and diving personnel. The well-developed frontal sinus is most vulnerable, followed by the maxillary sinus. The ethmoid sinus volume is small, and the sphenoid sinus opening is large and less affected. Mainly for the forehead or cheeks, varying degrees of pain, accompanied by pain in the roots of the teeth, occasional nosebleeds, eye pain, tearing and blurred vision. Lighter hours or days can be gradually restored, and severe cases often last for several weeks to heal. Patients with combined purulent infections have worsened symptoms for a longer period of time with fever.

Cause

The sinus opening of normal people is often kept open. When the plane rises and the outside air pressure is lower than the sinus air pressure, the air in the sinus escapes through the sinus. When the plane descends, the external air pressure is higher than the sinus air pressure, and the outside air enters the sinus through the sinus. Therefore, the pressure inside and outside the sinus can be quickly balanced. If the sinus is affected by certain diseases, such as acute and chronic rhinitis, allergic rhinitis, nasal polyps, nasal septum deviation, etc., ventilation is impeded. When the airplane rises, the sinus air pressure is higher than the outside air pressure, and the air can barely escape. When the plane drops rapidly, the diseased tissue near the sinus mouth is compressed by the outer boundary pressure to block the sinus ostium, the air can not enter the sinus, the pressure inside and outside the sinus is out of balance, and the sinus becomes a relative negative pressure. The faster the aircraft descends, the greater the pressure difference between the internal and external sinus, the negative pressure in the sinus can produce a series of pathological changes. If the original inflammation exists in the nose, it can induce symptoms of sinusitis. Mainly for the forehead pain or numbness of the cheeks and molars, occasionally with a snot, occasionally a shock occurred.

an examination

First, physical examination

Taking a medical history gives us a first impression and revelation, and also guides us to a concept of the nature of the disease.

Second, laboratory inspection

Laboratory examinations must be summarized and analyzed based on objective data learned from medical history and physical examination, from which several diagnostic possibilities may be proposed, and further consideration should be given to those examinations to confirm the diagnosis. Such as:

1, nasal examination: visible mucosal congestion and serous blood secretions, mucosal swelling or polyps near the sinus mouth.

2, X-ray sinus film: showing sinus mucosa thickening or liquid level, hematoma can be seen semi-circular shadow.

Differential diagnosis

Differential diagnosis of sinus barotrauma:

1, sinus tenderness: sinusitis, nasal congestion, runny nose, headache and sinus tenderness. Patients with acute sinusitis may be associated with fever and general malaise. Nasal or nasal endoscopy revealed swelling of the nasal mucosa, purulent secretions in the middle nasal passage or olfactory fissure, and tenderness in each corresponding sinus area.

2, nasal mucosa ulcer: nodular infiltration under the nasal mucosa, followed by erosion, can lead to scar adhesion. In the late stage, there was atrophy due to dryness and scarring of the nasal cavity. The anterior nares are narrow. The nasal mucosa is pale and thick, and the secretions increase. There may be purulent sputum and nosebleeds, but the patient may not feel pain.

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