Barotraumatic sinusitis and rhinosinusitis: Risk mitigation, prevention, and treatment strategies.

摘要

Introduction. Barotraumatic rhinosinusitis is an incapacitating, severe manifestation of a pre-existing rhinosinusitis and usually occurs upon a perturbation in atmospheric pressure such as might be confronted in an aircraft on descent or in the scuba diving scenario. Most rhinosinusitis is viral in nature yet an extraordinary amount of U.S. healthcare dollars are spent in treating this disease---often with the injudicious use of antibiotics.;Methods. A narrative literature review was performed to investigate the current literature of rhinosinusitis, barotraumatic sinusitis, evidence-based approaches to evaluating and treating this disease, and clinical practice guidelines.;Results. The results of this research enabled the author to create, using the most current available literature, a relevant, evidence-based, methodological, clinical practice guideline, which will be presented to the Aerospace Medical Association for use in evaluating and treating these disorders.;Conclusions. Evidence-based clinical practice guidelines using Cochrane's Criteria for evaluating rhinosinusitis, primary and tertiary prevention strategies, and current pharmacological advances can treat this disorder successfully, prevent barotraumatic sinusitis, save U.S. healthcare dollars, and decrease antibiotic resistance, one of the most serious public health concerns facing the United States.