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Type: Journal article
Title: Barosinusitis: comprehensive review and proposed new classification system
Author: Vaezeafshar, R.
Psaltis, A.J.
Rao, V.K.
Zarabanda, D.
Patel, Z.M.
Nayak, J.V.
Citation: Allergy and Rhinology, 2017; 8(3):109-117
Publisher: SAGE Publishing
Issue Date: 2017
ISSN: 2152-6567
Statement of
Reza Vaezeafshar, Alkis J. Psaltis, Vidya K. Rao, David Zarabanda, Zara M. Patel and Jayakar V. Nayak
Abstract: Background: Barosinusitis, or sinus barotrauma, may arise from changes in ambient pressure that are not compensated by force equalization mechanisms within the paranasal sinuses. Barosinusitis is most commonly seen with barometric changes during flight or diving. Understanding and better classifying the pathophysiology, clinical presentation, and management of barosinusitis are essential to improve patient care. Objectives: To perform a comprehensive review of the available literature regarding sinus barotrauma. Methods: A comprehensive literature search that used the terms "barosinusitis," "sinus barotrauma," and "aerosinusitis" was conducted, and all identified titles were reviewed for relevance to the upper airway and paranasal sinuses. All case reports, series, and review articles that were identified from this search were included. Selected cases of sinus barotrauma from our institution were included to illustrate classic signs and symptoms. Results: Fifty-one articles were identified as specifically relevant to, or referencing, barosinusitis and were incorporated into this review. The majority of articles focused on barosinusitis in the context of a single specific etiology rather than independent of etiology. From analysis of all the publications combined with clinical experience, we proposed that barosinusitis seemed to fall within three distinct subtypes: (1) acute, isolated barosinusitis; (2) recurrent acute barosinusitis; and (3) chronic barosinusitis. We introduced this terminology and suggested independent treatment recommendations for each subtype. Conclusion: Barosinusitis is a common but potentially overlooked condition that is primed by shifts in the ambient pressure within the paranasal sinuses. The pathophysiology of barosinusitis has disparate causes, which likely contribute to its misdiagnosis and underdiagnosis. Available literature compelled our proposed modifications to existing classification schemes, which may allow for improved awareness and management strategies for barosinusitis.
Rights: This work is published and licensed by OceanSide Publications, Inc. The full terms of this license are available at, and incorporate the Creative Commons License Deed: Attribution – Non-Commercial 4.0 Unported (CC BY-NC 4.0). By accessing the work you hereby accept the terms. Non-commercial uses of the work are permitted without any further permission from OceanSide Publications, Inc., provided the work is properly attributed. Any use of the work other then as authorized under this license or copyright law is prohibited.
RMID: 0030080553
DOI: 10.2500/ar.2017.8.0221
Appears in Collections:Medicine publications

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