Middle Ear Barotrauma in Student Pilots

INTRODUCTION: The present study reports the clinical features of middle ear barotrauma in student pilots in the Republic of Korea Air Force. METHODS: The authors reviewed medical records of student pilots with barotrauma. The grade of barotrauma was assigned using Teed's classification. This study included nasal symptoms, endoscopic findings of the nasal cavity, and clinical course (duration, recurrence). The relationship between middle ear barotrauma and the nasal airway was also evaluated. RESULTS: There were 57 cases in 51 pilots included. There were 49 cases (86.0%) that showed unilateral disease and 4 subjects experienced relapse. Two subjects (3.9%) had chronic rhinosinusitis and four subjects (7.8%) had allergic rhinitis. Ear fullness was reported in all cases, while hearing loss and persistent ear pain were reported in 3 cases (5.3%) and 19 cases (33.3%), respectively. Stuffy nose (26 cases, 45.6%) and rhinorrhea (24 cases, 42.1%) were relatively common. Most cases were Grade 0 (23 cases, 40.3%) or Grade III (27 cases, 47.4%) according to Teed's classification. Septa! deviation was observed in 12 cases (21.0%), while turbinate hypertrophy was seen in 53 cases (93.0%) and increased nasal discharge in 33 cases (57.9%). The grade of barotrauma varied significantly according to the severity of turbinate hypertrophy and nasal discharge. The mean duration of disease was 6.8 d. DISCUSSION: Nasal symptoms and endoscopic findings showed some association with the grade and duration of barotrauma. Most cases resolved within a week; however, barotrauma showed persistence or relapse in some cases.