Elsevier

American Journal of Otolaryngology

Volume 33, Issue 4, July–August 2012, Pages 477-480
American Journal of Otolaryngology

Case report
Sphenoid sinus barotrauma after scuba diving

https://doi.org/10.1016/j.amjoto.2011.10.017Get rights and content

Abstract

We report the case of an 18-year-old male patient operated on for sphenoid sinus barotrauma after scuba diving. The patient attended our emergency department because of intractable headache but did not improve with conservative treatment. After computed tomography and magnetic resonance imaging examination, he was diagnosed with sphenoid sinusitis that extended to the nasal septum. He therefore underwent surgery for sinus ventilation and abscess drainage.

Introduction

Barotrauma is tissue injury associated with rapid pressure change [1]. Most cases of barotrauma are related to air travel and cause middle ear and inner ear injury, but sometimes, barotrauma of the paranasal sinus is reported after air travel [2]. Reports of sinus barotrauma related to marine sports such as scuba diving or diving are uncommon, and sinus barotrauma caused by diving generally involves the frontal sinus or maxillary sinus [3].

Recently, we encountered a case of barotrauma of the sphenoid sinus after scuba diving, which progressed to a septal abscess and was treated by surgical management. Sinus barotrauma is thought to have increased significantly with the diversification of leisure activities and greater public involvement in marine sports.

Section snippets

Case

A previously healthy 18-year-old male patient visited our hospital emergency department because of a bilateral temporo-occipital area headache that had gradually worsened. The headache had been caused by scuba diving without a pressure control device 3 weeks previously, and immediately, after the scuba diving, mild epistaxis had occurred. As the patient's symptoms improved after symptomatic treatment, he was discharged without admission. After returning home, his headache worsened, so he was

Discussion

Sinus barotrauma is an inflammatory disease of the paranasal sinus related to rapid pressure change and associated with obstruction of the sinus opening due to upper airway infection, allergy, nasal polyp, or chronic sinusitis[1]. This disease readily occurs in professional pilots and divers but can also affect airplane passengers and people who enjoy scuba diving as a leisure sport.

The frontal sinus is the most commonly involved sinus, and if the frontal sinus is affected, headache occurs in

Conclusion

Sinus barotrauma can be easily diagnosed by detailed history taking and physical and radiologic examination. Rapid diagnosis is important for treatment, so physicians should be aware of this disease. Because sinus barotrauma is expected to increase with the diversification of leisure activities and the increase in marine sports, we need to be concerned with the diagnosis and treatment of this disease.

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