Treatment of Recurrent Sinus Barotrauma in Aviators: Comparison of Functional Endoscopic and “Classic” Sinus Surgery Techniques

Recurrent sinus barotrauma in an aviator is difficult to treat successfully. Exacerbation frequently results in marked discomfort, cycles of temporary restriction from aviation duties, or even permanent disqualification from flight duties. Medical management and “classic” sinus operations are often ineffective and seldom curative and have a disappointing record in returning the aviator to flying duties. Conversely, detailed computed tomographic scanning of the paranasal sinuses coupled with the functional endoscopic sinus surgery approach directs treatment at the causative pathologic condition, thereby improving sinus ventilation and making possible a return to active flight status without recurrence of sinus barotrauma. Initial experience with the functional endoscopic sinus surgery technique in such a patient population is reported and its effectiveness is compared to that of classic sinus surgeries, such as Caldwell-Luc and frontal sinus trephination, in treating aviators with recurrent sinus barotrauma.