Sinus Barotrauma in Divers

Fagan, Paul; McKenzie, Bart; Edmonds, Carl

doi:10.1177/000348947608500110

Cited by 50 publications

(35 citation statements)

References 2 publications

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“…Patients with history of sinusitis, otitis media or an upper respiratory infections may have a higher frequency of sinus barotrauma [6], [7], [33]. This could be because the sinus cavities communicate with the nasal cavities through ostia and through a long and tortuous duct in the sinuses.…”

Section: Discussionmentioning

confidence: 99%

MRI Findings of Otic and Sinus Barotrauma in Patients with Carbon Monoxide Poisoning during Hyperbaric Oxygen Therapy

et al. 2013

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Background and PurposeTo study the MRI findings of otic and sinus barotrauma in patients with carbon monoxide(CO) poisoning during hyperbaric oxygen (HBO) therapy and examine the discrepancies of otic and sinus abnormalities on MRI between barotrauma and acute otitis media with effusion.Materials and MethodsEighty patients with CO-poisoning diagnosed with otic and sinus barotrauma after HBO therapy were recruited. Brain MRI was performed to predict delayed encephalopathy. Over the same period, 88 patients with acute otitis media with effusion on MRI served as control. The abnormalities of the middle ear and paranasal sinuses on MRI were noted and were compared between groups. Nine patients with barotrauma were followed up by MRI.ResultsIn the barotrauma group, 92.5% of patients had bilateral middle ear abnormalities on MRI, and 60% of patients had both middle ear cavity and mastoid cavity abnormalities on MRI in both ears. Both rates were higher than those in the control group (p = 0.000). In the two groups, most abnormalities on MRI were observed in the mastoid cavity. The rate of sinus abnormalities of barotrauma was 66.3%, which was higher than the 50% in the control group (p = 0.033). In the nine patients with barotrauma followed up by MRI, the otic barotrauma and sinus abnormalities had worsened in 2 patients and 5 patients, respectively.ConclusionMRI is able to depict the abnormalities of otic and sinus barotrauma in patients with CO-poisoning during HBO therapy and to differentiate these from acute otitis media with effusion.

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Section: Discussionmentioning

confidence: 99%

MRI Findings of Otic and Sinus Barotrauma in Patients with Carbon Monoxide Poisoning during Hyperbaric Oxygen Therapy

et al. 2013

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“…During ascent, epistaxis may occur, because expansion of enclosed air expels blood mixed with mucus from the sinus ostium [11][12][13]. Paranasal sinus barotrauma of ascent, also termed 'reverse sinus squeeze', occurs due to the inability of expanding air during diving ascent to escape when a sinus ostium becomes blocked at depth.…”

Section: Discussionmentioning

confidence: 99%

Medical and surgical treatment in divers with chronic rhinosinusitis and paranasal sinus barotrauma

Skevas

Baumann

Brückner

et al. 2011

Eur Arch Otorhinolaryngol

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Aim of the study is to evaluate the effects of medical and surgical treatment in divers with paranasal sinus barotrauma (PSB) secondary to chronic rhinosinusitis (CRS). In this retrospective, cross-sectional, descriptive study 40 adult divers with CRS were included. Treatment of divers implied a 5-day course of a systemic steroid and a 6-week course of saline nasal irrigations and topical nasal steroid with mometasone in maximal dosage. If symptoms persisted, functional endoscopic sinus surgery (FESS) was performed. Questionnaires included the Sinonasal Outcome Test-20 German Adapted Version (SNOT-20 GAV), dive-related questions (DRQ) and general questions. Questionnaires were completed retrospectively by recalling the symptoms before and after therapy. Forty of 82 divers completed the questionnaires. Mean follow-up was 42 months (range 13-95 months). There was a statistically significant improvement of the Total score (TS) and of every subscore, except the General Quality of Life score, in the SNOT-20 GAV as well as of the TS in the DRQ. Before treatment, divers who required surgery reported significantly more symptoms than divers who were treated conservatively. Post treatment there were no significant differences between the medical and surgical group. Overall, 35 divers could resume diving after therapy even though PSB still occurred but without complications. Divers with sinus problems can successfully be managed medically and if conservative treatment fails, FESS shows a statistically significant improvement of symptoms and no serious long-term hazards for diving.

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“…Barotrauma may range in severity from 'mask squeeze' with facial bruising, barodontalgia or 'tooth squeeze' , ear injuries from bruising through to round window rupture, gastric injuries such as esophageal rupture, and PBT including emphysemas (subcutaneous or mediastinal), pneumothorax, up to the most serious of diving injuries; AGE, particularly the cerebral form (CAGE), a leading cause of death or drowning among recreational diving fatalities [21,25,[67][68][69][70][71][72][73][74][75][76][77][78][79]. DCS, now widely accepted as attributable to the liberation of gas from solution to form bubbles in the tissues, manifests in seriousness ranging from the type I symptoms of skin rash, pain only and general malaise, through to the neurological type II symptoms of motor function impairment, loss of bladder control, sensory impairment, permanent paralysis and even, ultimately, death [72,[80][81][82][83][84].…”

Section: Injury Severitymentioning

confidence: 99%

The Epidemiology of Injury in Scuba Diving

Buzzacott

2012

Medicine and Sport Science

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The epidemiology of injury associated with recreational scuba diving is reviewed. A search of electronic databases and reference lists identified pertinent research. Barotrauma, decompression sickness and drowning-related injuries were the most common morbidities associated with recreational scuba diving. The prevalence of incidents ranged from 7 to 35 injuries per 10,000 divers and from 5 to 152 injuries per 100,000 dives. Recreational scuba diving fatalities account for 0.013% of all-cause mortality aged ≥ 15 years. Drowning was the most common cause of death. Among treated injuries, recovery was complete in the majority of cases. Dive injuries were associated with diver-specific factors such as insufficient training and preexisting medical conditions. Environmental factors included air temperature and flying after diving. Dive-specific factors included loss of buoyancy control, rapid ascent and repetitive deep diving. The most common event to precede drowning was running out of gas (compressed air). Though diving injuries are relatively rare prospective, longitudinal studies are needed to quantify the effects of known risk factors and, indeed, asymptomatic injuries (e.g. brain lesions). Dive injury health economics data also remains wanting. Meanwhile, health promotion initiatives should continue to reinforce adherence to established safe diving practices such as observing depth/time limits, safety stops and conservative ascent rates. However, there is an obvious lack of evaluated diving safety interventions.

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Sinus Barotrauma in Divers

Cited by 50 publications

References 2 publications

MRI Findings of Otic and Sinus Barotrauma in Patients with Carbon Monoxide Poisoning during Hyperbaric Oxygen Therapy

MRI Findings of Otic and Sinus Barotrauma in Patients with Carbon Monoxide Poisoning during Hyperbaric Oxygen Therapy

Medical and surgical treatment in divers with chronic rhinosinusitis and paranasal sinus barotrauma

The Epidemiology of Injury in Scuba Diving

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