Sinus barotrauma

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Background

  • Also known as "sinus squeeze"
  • Occurs during scuba diving or air flight due to changes in pressure within a non-draining sinus.
The four facial sinuses

Clinical Features

  • Pain over affected sinus, possible bleeding from nares
  • Ascent can cause expulsion of blood and mucous into nares and mask.
  • Front sinus most commonly affected, followed by maxillary sinus
    • Infraorbital branch of fifth cranial nerve runs along base of maxillary sinus, and can have neuropraxia involving lip and cheek.
    • Teeth pain can occur.
    • Ethmoid sinus can dissect air through lamina papyracea and cause periorbital emphysema.

Differential Diagnosis

Diving Emergencies

Barotrauma Types

Evaluation

  • Usually clinical

Management

  • Decongestants (pseudoephedrine, oxymetazoline)
  • Consider antibiotics

Disposition

  • Generally discharge

See Also

External Links

References