Post stapedotomy aviation: A changing scenario

Abstract

Aeromedical implications of stapedotomy like rapid barometric changes and G forces are generally thought to put an end to the aviation career of an aviator. Aviation industry has grown tremendously in the last few decades, and aviation now is not only occupational but also recreational. The Indian Military Aviation rules state that, “Stapedectomy cases will be assessed permanently unfit for flying duties. These cases will be cautioned against flying in an unpressurised aircraft.” The basis of this is the aeromedical concerns associated with stapedotomy as clinical conditions which are of minor significance on the ground may become aggravated in the air. With an ever expanding civil and military aviation industry, the number of aviators who have undergone stapedotomy has also increased. Though grounding the aircrew is the safest option, but if medical certification is denied to all, then the majority who can fly safely will also be excluded, thus denying the organization of its trained resources. This paper discusses post otosclerosis and post stapedotomy aeromedical concerns, reviews existing literature concerning post stapedotomy aviation and various post stapedotomy aviation policies.

Flight After Stapes Surgery: An Evidence‐Based Recommendation

“…The study discussed a protocol for evaluating aircrew members after surgery to return to flight and, based on their review of a variety of cases in their archive dating to before the guidelines era, recommended a grounding duration of 3‐ to 6 months postop provided that all testing is normal 3 . The more recent guidelines of the US Navy, US Air Force, and National Aeronautics and Space Administration (NASA), however, require a 3‐month grounding period with the absence of any hearing loss or vertigo in the postop period after a stapedectomy 4 . Military aircrew, however, are subjected to very rapid altitude changes and significant accelerations, not typically experienced in commercial flights.…”

“… 3 The more recent guidelines of the US Navy, US Air Force, and National Aeronautics and Space Administration (NASA), however, require a 3‐month grounding period with the absence of any hearing loss or vertigo in the postop period after a stapedectomy. 4 Military aircrew, however, are subjected to very rapid altitude changes and significant accelerations, not typically experienced in commercial flights.…”