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Open Access Barosinusitis: Comprehensive review and proposed new classification system

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Background:

Barosinusitis, or sinus barotrauma, may arise from changes in ambient pressure that are not compensated by force equalization mechanisms within the paranasal sinuses. Barosinusitis is most commonly seen with barometric changes during flight or diving. Understanding and better classifying the pathophysiology, clinical presentation, and management of barosinusitis are essential to improve patient care.

Objectives:

To perform a comprehensive review of the available literature regarding sinus barotrauma.

Methods:

A comprehensive literature search that used the terms “barosinusitis,” “sinus barotrauma,” and “aerosinusitis” was conducted, and all identified titles were reviewed for relevance to the upper airway and paranasal sinuses. All case reports, series, and review articles that were identified from this search were included. Selected cases of sinus barotrauma from our institution were included to illustrate classic signs and symptoms.

Results:

Fifty-one articles were identified as specifically relevant to, or referencing, barosinusitis and were incorporated into this review. The majority of articles focused on barosinusitis in the context of a single specific etiology rather than independent of etiology. From analysis of all the publications combined with clinical experience, we proposed that barosinusitis seemed to fall within three distinct subtypes: (1) acute, isolated barosinusitis; (2) recurrent acute barosinusitis; and (3) chronic barosinusitis. We introduced this terminology and suggested independent treatment recommendations for each subtype.

Conclusion:

Barosinusitis is a common but potentially overlooked condition that is primed by shifts in the ambient pressure within the paranasal sinuses. The pathophysiology of barosinusitis has disparate causes, which likely contribute to its misdiagnosis and underdiagnosis. Available literature compelled our proposed modifications to existing classification schemes, which may allow for improved awareness and management strategies for barosinusitis.
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Keywords: Barosinusitis; aerosinusitis; diving; flight sinusitis; hyperbaric oxygen therapy; recurrent sinusitis; sinus barotrauma; sinus headache; sinus pressure; vacuum sinusitis

Document Type: Research Article

Publication date: 2017-10-01

More about this publication?
  • In the fields of rhinology & allergy, as in all medical fields, there is a need for a greater number of journals which publish in the open access format. The underlying spirit of this format is to break down the barriers to knowledge sharing. Allergy & Rhinology, was created to serve this need; and is proud to take the lead in publishing quality research work as an experiment in the open format. As long as the fiscal model works, the Journal shall allow all users the right to freely read, download, copy, distribute, print, search, or link to the full texts of its articles.

    The academic standard of Allergy & Rhinology is designed to be no different than traditional subscription-based, scientific and scholarly journals in that the quality of the research work which it publishes shall meet the rigors of peer-review and other scholarly quality controls.

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