It Hurts in Flight – Sinus Barotruama

Sinuses are small air filled spaces in the bones of the skull. These sinuses drain into the nasal cavity through small openings, which allow easy ventilation of air during ascent and descent. 

Any obstruction to the sinus openings will adversely affect the ventilation of sinuses and result in Sinus Barotrauma (a.k.a Barosinusitis). Such an obstruction to the sinus openings can be due to the following reasons:-

  • Inflammation or infection in the nose as in cold, allergy, etc.
  • Any deformity of the walls of the nose or any growth, e.g., polyp etc.

Sinus Barotrauma, thus occurs due to pressure changes during flying in a sinus with blocked opening. It presents with pain in and around the affected sinus. Though, it occurs less commonly than Otitic Barotrauma; it does not get relieved by voluntary efforts since sinuses cannot be ventilated actively by manoeuvres like Valsalva.

The main symptom of Sinus Barotrauma is pain over the affected sinus. There may be accompanying headache, which may be severe and incapacitating. As per the site, it may present in the following ways:-

  • Frontal Sinus – The pain extends over the forehead above the bridge of the nose.
  • Maxillary sinuses – The pain is localised over the cheek. This may sometimes be referred to the teeth of upper jaw giving a false impression that the problem is in the teeth.

The immediate treatment of Sinus Barotrauma, when it occurs in flight, is to ascend to the altitude where the pain was first felt. It is prudent to abort the mission, and aircraft must descend as slowly as possible to minimise pain and discomfort.

Ideally, Sinus Barotrauma can be prevented by adequate and timely treatment of nose infections, while avoiding flying until recovered fully.

Read More


1. Ernsting’s Aviation Medicine. Rainford DJ, Gradwell DP (Editors). 4th Edition. Hodder Arnold, London 2006.

2. Fundamentals of Aerospace Medicine. DeHart RL, Davis JR (Editors). 3rd Edition. Lippincott, Williams & Wilkins, Philadelphia 2002.

3. Human Performance & Limitations – JAA ATPL Theoretical Knowledge Manual. 2nd Edition. Jeppesen GmbH, Frankfurt 2001.

Acknowledgement  Image courtesy and Wikimedia Commons

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