Clinical diagnosis, treatment and medical evaluation of barosinusitis in aircrew

Abstract

Objective To sum up the experiences of clinical diagnosis, treatment and suggest medical evaluation of barosinusitis in physical examination of aircrew.Methods Case studies of barosinusitis were made in 73 aircrew (3 female and 70 males aged from 21-51 years). Such items as location, classification, type and graduate of barosinusitis, as well as treatment and final evaluation were statistically analyzed by means of SPSS 11.0 software.Results ① There were 56 cases of class Ⅱ_a (barosinusitis only)and 17 cases of class Ⅱ_c (barosinusitis and barotrauma of ear)based on diagnosis. ② For location, 54 cases of were in frontal sinus, 10 in maxillary sinus, 3 in ethmoid sinus, 2 in sphenoid sinus, 2 in frontal sinus and maxillary sinus, and 2 in frontal sinus and ethmoid sinus. ③ Twenty-four cases were classified as primary barotraumas that resulted from abnormal of sinus ostium while other 49 cases were the secondary barotraumas that resulted from the pathological change around sinus ostium. ④ In type statistics, 15 cases were the type Ⅰ (the type of anatomical abnormalities in nasal cavity), 25 for type Ⅱ (the type of inflammation), 8 for type Ⅲ (the type of allergy), and 10 for type Ⅳ (the type of tumor). Among them, 7 cases were simultaneously diagnosed as 2 types of barotraumas and 1 case had 3. There were 7 cases of in-sinus type and 42 outsinus type. ⑤ For graduate analysis, 34 cases (46.6%) were mild and 39 cases (53.4%) were severe. ⑥ For final evaluation, 62 cases were qualified while the other 2 and 9 cases were respectively decided as temporary and permanent grounding.Conclusions The incidence ratio of barosinusitis in frontal sinus is the highest.Classifying, typing and graduating barotraumas indicate important significance to clinical aviation medicine. The incidence ratio of secondary barosinusitis is higher than that of primary and the type Ⅱ is the main reason that causes the pathological changes around sinus ostium. Operation is suggested for severe barosinusitis. The class Ⅱ_c barotraumas would mostly result in aircrew grounded. Key words: Paranasal sinuses; Barotrauma; Diagnosis; Eligibility determination