![]() ![]() As the ambient pressure decreases while ascending, the volume of the gas increases proportionately. According to Boyle’s Law, as the ambient pressure increases while descending, the volume of the gas in an enclosed space decreases proportionately. The pressure diminishes by the same amount on ascent. Mechanisms of InjuryĮvery foot of descent in water adds approximately one-half pound of pressure on each square inch of tissue. Ostia blockage can impair drainage and make both descents and ascents troublesome. The ostia can easily be blocked by inflammatory processes, like colds or allergies, and in divers by improper attempts at equalization. The paranasal sinuses communicate with the nasal cavity via small orifices called ostia (singular: ostium). ![]() The maxillary sinuses (area four) are located within the maxillary bone below your eyes and lateral to your nose and are the largest pair of paranasal sinuses.The sphenoidal sinuses (area three) are centrally located behind the nasal cavity and vary in size and shape.The ethmoid cells (area two) are located within the ethmoid bone between your eyes and nose and are formed by a variable number of connected individual cells.The frontal sinuses (area one) are located within the forehead above your nose and eyes and are surrounded by thick, bony walls.There are two sets of four sinus cavities, one set on the right and one on the left. They have several functions: They lighten the weight of your head, play a significant role in the resonance of your voice, serve as collapsible structures that protect vital organs during facial trauma, and may help the turbinates (small structures inside the nose) humidify and heat the air we breathe. The paranasal sinuses are gas-filled cavities in your facial bones and skull. Anatomy and Functions of the Paranasal Sinuses Divers should never underestimate difficulties equalizing sinuses. Although sinus barotrauma is a prevalent and generally benign diving injury, some of its complications could pose a significant risk to the diver’s health. When the paranasal sinuses fail to equalize to barometric changes during vertical travel, damage to the sinus can cause sharp facial pain with postnasal drip or a nosebleed after surfacing. Air Force flyers were grounded for a total of 1,182 days with the primary diagnosis of aerosinusitis.Sinus barotraumas are among the most common diving injuries. Thus the essential environmental requirement for the development of sinus barotrauma is frequently present, and cases of aerosinusitis are common. 1 However, in certain military aircraft, particularly high-performance jet fighters, various maneuversĬreate marked and rapid changes in barometric pressure despite cabin pressurization. Severe aerosinusitis rarely occurs during flight in civilian aircraft, because the fluctuation of barometric pressure is usually well controlled by cabin pressurization and gradual ascent and descent. This lesion filled the sinus, occluded the nasofrontal duct, and required surgical intervention. However, in the case to be presented here, barotrauma produced a frontal sinus hematoma which subsequently enlarged to form a hemorrhagic cyst. Ordinarily this disease responds quickly to conservative treatment as outlined in standard otolaryngologic texts. Aerosinusitis continues to occur with significant frequency. ![]()
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