The application of endoscopic sinus surgery to the treatment of recurrent sinus barotrauma.

Recurrent sinus barotrauma is an uncommon condition but it may terminate the career of an aviator. Sinus barotrauma occurs almost exclusively on descent and probably results from occlusion of the sinus ostia through a combination of mucosal disease and anatomical abnormalities. Traditional methods of treating sinus barotrauma have achieved mixed results so we have employed functional endoscopic sinus surgery (FESS) since 1990. The presentation and outcome of 39 patients with recurrent sinus barotrauma managed by FESS have been reviewed. Ninety-five per cent were able to resume their full flying duties without further treatment or recurrence of sinus barotrauma. Passing a postoperative decompression testing is a reliable indicator of an aviators's fitness to fly after FESS.