![]() ![]() This inflammation was possibly initiated after an upper respiratory tract infection or allergic rhinitis. In our case, the tortuous and narrow right nasofrontal duct to the middle meatus in the nasal cavity was obstructed due to mucosal inflammatory changes illustrated on CT (Figure C). Normally, the ostium of each sinus opens into the nasal cavity, allowing equalization of air pressure. ![]() It postulates the absolute pressure of an ideal gas being inversely proportional to the volume it occupies if the temperature remains unchanged within a closed system. The pathophysiology of sinus barotraumas is related to Boyle-Mariotte’s law. This pathologic condition occurs most commonly in scuba divers and flight passengers subjected to abrupt pressure changes. Sinus barotrauma is a tissue injury caused by a rapid change in barometric pressure difference between the intrasinusal air and the surrounding atmosphere. Conservative treatment with oral decongestants and analgesics resulted in satisfactory symptom relief. Considering the clinical history and MRI appearance, the diagnosis of submucosal hematoma secondary to barotrauma was made. A polypoid mass was noted in the right frontal sinus, hyperintense on T1- and T2-weighted images, without enhancement after contrast administration (Figures A and B). No intracranial mass, hemosiderin deposits, or arteriovenous malformation were observed. Because of the atypical and persistent headache, MRI imaging was performed to exclude underlying pathology. The pain was nothing like previous migraine headaches she had experienced.Ī noncontrast CT scan was performed which showed no apparent abnormal findings, except for a soft tissue density in the right frontal sinus, initially interpreted as an inflammatory mucosal swelling. Only a minor respiratory tract infection was noted two weeks before this episode, and she had no history of sinus problems. There were no visual or hearing deficits, head trauma, or epistaxis, and she experienced no difficulty clearing her ears during the flight. The pain started during the descent of a jet airplane on a holiday trip. ![]() Because visual recovery depends on prompt diagnosis and proper therapy, physicians like otolaryngologists, ophthalmologists and neurologists need to closely collaborate.A 58-year-old woman visited our hospital’s emergency department because of a severe and increasing pain over the right occipital region, irradiating over the right frontal area. We show that injuries can develop from both negative and positive pressures in the sinuses. Divers and physicians should have in mind that occasional headache during or after diving sometimes signals serious neurological disorders like vision loss. on anatomical and pathophysiological features. After searching the literature (Medline) and other sources (Internet), we present some cases of sphenoid sinus barotrauma, because these injuries may be underreported and misdiagnosed due to the lack of awareness and knowledge. Thus, barotrauma could lead to serious neurologic disorders, including blindness. Vital structures, as internal carotid artery and optic nerve, adjoin the sphenoid sinus. The sphenoid sinuses are rarely involved. About 50% of scuba divers have suffered from barotrauma of the ears and about one-third from barotrauma of paranasal sinuses. ![]()
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