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Aerosinusitis symptoms2/11/2024 Stage III lesions are rarely seen in civilian air travelers due to the relatively low fluctuations in ambient air pressure. Additionally, antihistamines are reserved for cases where allergies were the inciting cause. Use of antibiotics is reserved for those cases initiated by bacterial sinusitis. Stage I or II lesions are generally treated conservatively with a 1-wk course of topical sprays, analgesics, a tapering course of steroids, and oral decongestants. Management of this condition is based on the Weissman stage. Categorization of the patient into the Weissman classification is important for determining prognostic factors for recovery. Evaluation of the patient presenting with aerosinusitis consists of a careful physical exam with emphasis on diagnosing treatable nasal and sinus pathology. Prophylaxis of this condition consists of an oral decongestant before flight and nasal decongestant spray during the flight just prior to descent. Patients presenting before flight with an upper respiratory infection are at risk for aerosinusitis. Endoscopic surgery to expand the natural drainage pathways of the affected sinuses with minimal surgical trauma to the healthy mucous membranes is largely successful. In part 2, diagnostic measures, drug therapy, balloon dilatation and endoscopic sinus surgery are presented, along with a discussion regarding when flight attendants and pilots are able to resume their work. ![]() Additionally, currently available monographs and further articles that could be identified based on the publication reviews were also included. This Continuing Medical Education (CME) article is based on selective literature searches of the PubMed database (search terms: "aerosinusitis", "barosinusitis", "barotrauma" AND "sinus", "barotrauma" AND "sinusitis", "sinusitis" AND "flying" OR "aviator"). Sinonasal diseases and anatomic variations leading to obstruction of paranasal sinus ventilation favor the development of aerosinusitis. Aerosinusitis more frequently affects the frontal sinus than the maxillary sinus and mostly occurs during descent.
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