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The surgical management of recurrent acute and chronic barosinusitis in sports self-contained underwater breathing apparatus (scuba) divers

  • Rhinology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Purpose

The aim of this retrospective study is to evaluate the feasibility of functional endoscopic sinus surgery (FESS) with supplementary surgical procedures in scuba divers with recurrent acute barosinusitis (RABS) and chronic barosinusitis (CBS).

Methods

In this retrospective study, 25 divers were classified into RABS (n:11) and CBS (n:14) groups. The presentation of divers have been reviewed. The PNS CT images were scored according to Lund–Mackay (L–M) system. A score has been assigned to the extent of endoscopic procedures performed. The outcome of surgery and life quality were determined by SNOT-22 and dive-related questions (DRQ) tests.

Results

The average L–M score was 3.8 ± 2 for RABS and 12.2 ± 3.4 for CBS groups. L–M score of CBS group was found to be statistically higher than RBS group (p < 0.05). The FESS score of CBS group (8.7 ± 2.4) was higher than RABS group (5.6 ± 2) which showed that the endoscopic sinus procedures were performed more extensively in CBS group (p < 0.05). The difference between the preoperative and postoperative SNOT-22 scores indicates that the degree of sinus symptoms improved better in RABS group than CBS group (p < 0.05). When DRQ test was evaluated, RABS group showed a better improvement in diving performance symptoms than the CBS group (p < 0.05).

Conclusion

Our study demonstrated that divers with RABS and CBS can be managed successfully with FESS and supplementary surgical procedures. The improvement in the RABS group was superior to the CBS group, a difference attributed to the severity of chronic inflammation in CBS.

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Authors and Affiliations

  1. Department of Otorhinolaryngology, İstanbul Medipol Hastanesi, Haydarpasa-Harem Yolu, Koşuyolu, Kadıköy, 34718, İstanbul, Turkey

    Özmen Öztürk

  2. Department of Otorhinolaryngology, Faculty of Medicine, Bahçeşehir University, İstanbul, Turkey

    Ziya Bozkurt

Authors
  1. Özmen Öztürk
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  2. Ziya Bozkurt
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Correspondence to Özmen Öztürk.

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Supplementary material 1 (XLSX 41 kb)

Appendix

Appendix

A modified version of dive-related questions (DRQ) questionnaire by Skevas Ref. [8].

 

Symptoms during diving

No problem

Very slight problem

Small problem

Moderate problem

Severe problem

Can’t get worse

1

Sinus pain during descent

0

1

2

3

4

5

2

Sinus pain during ascent

0

1

2

3

4

5

3

Sinus pain during the dive

0

1

2

3

4

5

4

Sinus pressure during descent

0

1

2

3

4

5

5

Sinus pressure during ascent

0

1

2

3

4

5

6

Sinus pressure during dive

0

1

2

3

4

5

7

Blood in the mask during diving

0

1

2

3

4

5

8

Epistaxis after dive

0

1

2

3

4

5

9

Ear equalization problem with Valsalva

0

1

2

3

4

5

10

Is your fitness to dive restricted?

0

1

2

3

4

5

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Öztürk, Ö., Bozkurt, Z. The surgical management of recurrent acute and chronic barosinusitis in sports self-contained underwater breathing apparatus (scuba) divers. Eur Arch Otorhinolaryngol 277, 2475–2484 (2020). https://doi.org/10.1007/s00405-020-06034-3

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  • DOI: https://doi.org/10.1007/s00405-020-06034-3

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