Pneumomediastinum in student aviators: 10 cases with return to flying duty

Pneumomediastinum (PnM) is an uncommon phenomenon, though it is one of the most common causes of chest pain in young adults. It may be particularly important among aviators, as it may result in in-flight incapacitation. Spontaneous PnM is a variant usually associated with the Valsalva maneuver, used during high-performance flight. This may increase the risk of PnM recurrence and raises concern regarding the return to flight duties of aviators after an episode of spontaneous PnM. We present 10 student aviators who experienced a single episode of uncomplicated PnM unassociated with flight. All were returned to flying duty following a normal pulmonary evaluation and are still in active duty. Follow-up was conducted for a mean period of 74.7 me without any adverse consequences. These findings support the return of aviators to flying duty after a single episode of uncomplicated spontaneous PnM.