Sinus barotrauma


The four facial sinuses
  • Also known as "sinus squeeze"
  • Occurs during scuba diving or air flight due to changes in pressure within a non-draining sinus.

Barotrauma Types

Diving Physiology

  • Pascals Law applies to the diving body (without air filled areas such as lungs) states that the pressure applied to any part of the enclosed liquid will be transmitted equally in all directions through the liquid.
  • Boyles Law applies to the diving body's air filled areas such as lungs, sinuses, middle ear, and states that the volume and pressure of a gas at a given temperature are inversely related.
    • At 2 ATA (10m/33ft) a given gas would be 1/2 it's volume, at 3 ATA (20m/66ft) it would be 1/3 it's volume and so on.
Boyle's Law

Clinical Features

  • Pain over affected sinus, possible bleeding from nares
  • Ascent can cause expulsion of blood and mucous into nares and mask.
  • Front sinus most commonly affected, followed by maxillary sinus
    • Infraorbital branch of fifth cranial nerve runs along base of maxillary sinus, and can have neuropraxia involving lip and cheek.
    • Teeth pain can occur.
    • Ethmoid sinus can dissect air through lamina papyracea and cause periorbital emphysema.

Differential Diagnosis

Diving Emergencies

Barotrauma Types


  • Usually clinical


  • Decongestants (pseudoephedrine, oxymetazoline)
  • Consider antibiotics


  • Generally discharge

See Also

External Links