Barosinusitis

Barosinusitis

Barosinusitis, also known as sinus barotrauma, is a condition characterized by inflammation and pain in the paranasal sinuses due to changes in ambient pressure. This condition is commonly experienced by individuals who undergo rapid altitude changes, such as pilots, divers, and passengers on airplanes.

Pathophysiology

Barosinusitis occurs when there is a failure to equalize the pressure between the sinus cavities and the external environment. The paranasal sinuses are air-filled spaces within the bones of the skull that are connected to the nasal cavity. Under normal circumstances, the pressure within these sinuses is equalized with the external atmospheric pressure through small openings called ostia.

When there is a rapid change in external pressure, such as during ascent or descent in an airplane or while diving, the pressure differential can cause the sinus ostia to become blocked. This blockage prevents the equalization of pressure, leading to a vacuum effect within the sinus cavity. The resulting negative pressure can cause the mucosal lining of the sinuses to swell, leading to pain and inflammation.

Symptoms

The symptoms of barosinusitis can vary depending on the severity of the condition and the specific sinuses involved. Common symptoms include:

• Facial pain or pressure, particularly around the forehead, eyes, and cheeks
• Headache
• Nasal congestion
• Reduced sense of smell
• Dizziness
• Ear pain or discomfort

Diagnosis

Diagnosis of barosinusitis is typically based on the patient's history and symptoms, particularly the correlation with changes in altitude or pressure. A physical examination may reveal tenderness over the affected sinuses. In some cases, imaging studies such as a CT scan of the sinuses may be used to confirm the diagnosis and assess the extent of sinus involvement.

Treatment

The primary goal of treatment for barosinusitis is to relieve symptoms and restore normal sinus drainage and pressure equalization. Treatment options may include:

• Decongestants to reduce nasal congestion and facilitate sinus drainage
• Analgesics for pain relief
• Nasal saline sprays or irrigation to keep the nasal passages moist
• In severe cases, oral corticosteroids may be prescribed to reduce inflammation

Preventive measures are also important, especially for individuals who frequently experience barosinusitis. These may include:

• Using decongestants or nasal sprays before flying or diving
• Performing the Valsalva maneuver to help equalize pressure
• Avoiding activities that involve rapid pressure changes when experiencing a cold or nasal congestion

Complications

If left untreated, barosinusitis can lead to complications such as chronic sinusitis, sinus infections, or even damage to the sinus structures. In rare cases, severe barotrauma can result in a sinus rupture.

Also see

• Sinusitis
• Barotrauma
• Valsalva maneuver
• Paranasal sinuses