Sinus barotrauma in diving

Abstract

Introduction: Sinus barotrauma is a common occurrence in diving and subaquatic medicine, potentially compromising dive safety. To gain a more thorough understanding of the condition, an in-depth investigation is justified. Methods: This was a survey study. An anonymous, electronic questionnaire was distributed to 7,060 recipients: professional divers of the Finnish Border Guard, the Finnish Rescue Services, and the Finnish Heritage agency, as well as recreational divers registered as members of the Finnish Divers’ Association reachable by email (roughly two-thirds of all members and recreational divers in Finland). Primary outcomes were self-reported prevalence, clinical characteristics, and health effects of sinus barotrauma while diving. Secondary outcomes were adjusted odds ratios (OR) for frequency of sinus barotrauma with respect to possible risk factors. Results: In total, 1,881 respondents participated in the study (response rate 27%). A total of 49% of the respondents had experienced sinus barotrauma while diving and of those affected, 32% had used medications to alleviate their symptoms. The factors associated with sinus barotrauma were pollen allergies (OR 1.59; 95% CI 1.10–2.29), regular smoking (OR 2.04; 95% CI 1.07–3.91) and a high number of upper respiratory tract infections per year (≥ 3 vs. < 3 infections per year: OR 2.76; 95% CI 1.79–4.24). Conclusions: Sinus barotrauma is the second most common condition encountered in diving medicine, having affected 49% of the respondents. Possible risk factors include allergies to pollen, regular smoking, and a high number of URTIs per year.

Dive Hazards: Barotrauma, Flora, Fauna, Equipment, and Free Diving

“…Divers should not dive with an upper respiratory infection or sinusitis to prevent sinus barotrauma. Smoking, nasal irritants, and headfirst diving increase the risk of both middle ear and sinus barotrauma and, therefore, should be avoided (12). Treatment of sinus barotrauma includes nasal and systemic decongestants, topical corticosteroids, and nasal irrigation (7).…”

“…Sinus barotrauma is the second most common dive-related injury, affecting almost 50% of divers (12). Sinus barotrauma results from obstruction of the paranasal sinuses in the setting of changing pressure.…”

“…Sinus barotrauma results from obstruction of the paranasal sinuses in the setting of changing pressure. Risk factors include the presence of seasonal allergies, smoking, and frequent URIs (>3 per year) (12). In almost all divers, sinus barotrauma presents with sinus pain on descent.…”