Extreme pain in forehead during descent/landing

[Simon10]

Want't to hear if any one out there has had any similiar problems. Since June last year I keep having extrem pain in my forehead, and moore to the left side of it during descent/approch fase. This rarely happens when I fly bigger machines like B737/MD80 but almost always happens in RJ200/BAe146/Fokker 50, since June last year.

I do fly a lot in my job, and this is really among the worst pains I've ever experienced. It all started in June. I am completly healthy except for this, and I even have tried to overspray before takeoff/approach with Nezeril/Otrivin (nose spray, don't know the proper word for it as I'm not english speaking by native).

Today I changed flight in Denmark but couldn't continue on to the next leg, I was in such disgustful pain so I had to cancel mid-way and fly back home. Any ideas is greatly appreciated.

[gingernut]

Sounds like a bit of air stuck in the frontal sinus cavities.


Probably worth a check out with the quack to rule anything obvious out, but it does sound like your symptoms are related to pressure changes. (Ever seen them bread roll wrappers blow up at altitude-simillar effect in the tubes running through your skull.)

Probably worth an ent consult and maybe a scan, especially considering the nature of your job.

[stevef]

I've had exactly the same pain when flying in unpressurised freighters on the descent phase. Something like a handful of hot needles rammed into my forehead. As you say, it's incapacitating. Blocked sinuses in my case.
Caused by the rate of descent (and pressurisation settings in passenger aircraft).

[kwachon]

Had a similar problem many moons ago, was told by doc to try a nasal strip and see if it helped, worked wonders, this led to having my sinus's cauterised and never had the problem again. :}

[PyroTek]

yep i got that, i initially thought it was barodontalgia (to do with teeth), but after a visit to my GP before i flew to europe for a holiday (i'm going home tomorrow :(, great skiing i must say!)

He told me that it was barotrauma with my sinus (most likely), and to take a sudafed (cold and flew pill) starting about 24 hours before my flight, however, i really only took the sudafed about an hour before the descent..

i'm not sure if it was just a phase that i had, i'm not sure if the sudafed fixed it, but loaded with sudafed it never seemed to come!

[Simon10]

Thank you all for your replies. In some way it feels good to know that I'm not the only one with this problem, however of course I'm not happy that others are suffering too... a great paradox I assume.

However, yesterday I went to see a ENT-specialist who by camera (or a small snake-looking devise) could see that the passage through the nose to the sinuses was swollen. So now I'm on cortison for six-months (!!!!!!) and some other kind of medication (de-swollowing). Sorry for my crap english medical terms. Tuesday I'm of to Paris and I am very curious/apprehensive on to what to expect when we start to descent...

Once again, thank you for taking your time to reply on my issue.

[PyroTek]

good to know :D

having swollen passages means the smallest amount of mucus/snot being caught in there can dry and block it, being the cause of the problem due to the air expanding on descent and not being released.

[gingernut]

Simon, seem a reasonable course of action, if the steroids are administered via a spray, don't expect instant results. (they'll probably take a few weeks to kick in).

[bluenose81huskys]

Your idea about this being related to your sinuses is a good one. Buy some decongestant nose drops from your local pharmacy. Next time you fly sniff one drop up each nostril 30 minutes before take-off and 30 minutes before descending. This should open the sinuses and prevent the pressure build up.

Hope this helps

[Pontius Navigator]

The problem with taking decongestants or flying with blocked sinuses is not simply the present pain or the pain relief; it is the subsequent consequences.

In the climb, as the cabin pressure reduces there will be a buildup of pressure in both the sinus and the inner ear. Both should vent naturally into the nasal passages. Any inflamation or congestion will then reseal the passages - you will feel stuffed up etc.

When the aircraft descends the pain will first be noticeable in the ears as external pressure on the tympanic membrane will cause pain and ultimately it might burst. You will not necessarily the sinus as the sinus cavity is surrounded by bone.

Now a decongestant will undoubtedly open up the eustachian tubes and allow pressure equalisation and also in the sinus cavities. Unfortunately there is an excellent chance that the gunge that closed the tubes in the first place, an excellent design feature, will get into the sinus cavity and the inner ear leading to infection and potentially deafness.

The moral? Don't fly with blocked sinus or a sever cold!

[piloteye]

I'm so glad it's not just me.
EVERY time I fly (but on descent only) I experience excruciating, crippling pain in my head, face, ears, and even down my neck. It feels as if my head is going to explode with the pressure.
The only thing that relieves it is Max strength Sudafed - and lots of it. I start taking it an hour before the plane is due to land. I know this isn't good for me, and I am certainly not suggesting this to anyone else, but believe me I would take anything, in any quantity to get rid of the pain. You have to experience it to believe it.

[piloteye]

Someone also once told me to massage the space between the little finger and ring finger. Whether the worst had passed by the time I started to do this in desparation, or not, it seemed to help.

[Pontius Navigator]

PE, pain killers are not the answer. You have two choices. Walk or medical.

The sinus is an obvious pain point especially as its drain point was designed for quaudripeds and not bipeds. This is why, after swimming, when you bend over water streams from your nose.

Another pain point and one which clears less easily are cheekbone cavities. Ear ache of course is by failure to clear your eustachion tubes.

Basically from what you have said you need urgent instruction in aviation medicine. There is a simple, and I am sure painless :} procedure to have the various passages reamed out so that they do not block.

You need to read up about the various baratraumas and ring NHS Direct. I suggest NHSD as it will give them time to read up or find a suitable expert. Your GP, unless you hit lucky, will know little more than you do. NHS D may then suggest surgery.

[MikadoTrident]

I don't fly for a living but this has happened three times to me in the past. Yes, one of the most painful expieriences of my life! I'm flying to Paris in a week and am getting paranoid about it happening then. What i'm hoping will work for me is taking sudafed and also inhaling tree tea oil.

Good luck.

[Pontius Navigator]

James,

How often has this happened? Everytime you fly or sometimes when you have flown?

Did have, or had you had a cold before you flew?

Had you been swimming?

If it has been only occasional, if you don't have a cold, and if you can easily clear your ears, then you should not have a problem.

Clearing ears and clearing sinuses is not the same thing but it is indicative of a problem or not.

There are several ways of clearing ears. Traditionally it was sucking a barley sugar during climb and descent. Alternatively waggling your jaw. Best, IMHO, is hold your nose and then gently increase the pressure in left nostril until that eardrum pops then repeat with the right. It may take practise but it is so long ago when I first did it :).

[MikadoTrident]

Hi,

This happened at all sorts of different times. First time was a flight to Geneva but on the return flight i was fine. Second was when i was flying a grob tutor and third time was flying to turkey but on the return flight i was fine :confused:. I had done some flights in between those and i was fine too. I did have a cold on two of the occasions but when i flew to turkey i didn't think i had a cold until then lol.

Thanks for advice.

[MikadoTrident]

And no, i hadn't been swimming lol.

[Pontius Navigator]

No worries then.

[Simon10]

I saw an ENT-doctor late January due to severe pain in my forehead during descent. Since then I got a steroids administered through nasal spray for use twice daily. Furthermoore I got the following instruction before going onboard a flight:

=>90 min. before takeoff 1 sudafed pill for anti-swolling
=>30 min. before takeoff 2 x showers in each nostril with Otrivin Decongestant Nasal Spray
=> immediately before take off: 1 x shower in each nostril with Otrivin
=> immediately before descent: 2 x showers of Otrivin in each nostril

This has helped me during all 7 of 8 flights since I started treatment. However, during one of the 8 flights I got back the pain in my forehead and immediately used lot's of nasal spray, which eased the pain to a bearable level.

I realize that this of course is not an long term solution and I most probably need to fix this problem by surgery. Foremost because using that much nasal spray is not good and one is at risk of developing a chronic nasal congestion.

Please, please..., don't apply this treatment on our your self before discussing with you doctor as It is only a personal recommendation.

[gasman123]

I suggest not using NHS direct, you will not get any sensible replies!

Option 1. Use Otrivine 30 mins before take-off. Quick fix, will work in many cases, however long term use will your nasal septum to erode. Not a permanent solution

Option 2. Work out what is actually wrong. Do you get hayfever/ allergy symptoms? Are your symptoms seasonal? Are you allergic to house dust/ pets etc? If so steroid sprays are likely to help. Modern sprays can give relief within 3 days, and some can be bought over the counter (eg Flixonase).

Option 3. Do it properly. See a GP, take their advice, and if things don't settle ask to be referred to an ENT surgeon. Before being considered for surgery decongestants and steroids will be tried, and a CT will be performed to check that your problems can be helped with surgery (not all can). The surgery involved is called FESS (functional endoscopic sinus surgery) - like all surgery it isn't without risk, the frontal sinuses are a tad close to the brain & the eyeballs! It has sorted out many professional pilots though.

Be careful taking decongestant tablets if flying, many are sedating & have been documented to cause CFIT.......

The pressure changes that develop in the ear in flying are not usually enough to cause permanent damage (unlike diving), but will disable & you certainly shouldn't be in control of a plane if you can't equalise or are getting distracting sinus pain.

[gingernut]

I suggest not using NHS direct, you will not get any sensible replies!

Come on, tell more, I could do with a laff.......:}

[gasman123]

alright!

Food poisoned twice by same curry house in Bristol, after 24 hours playing the porcelain trombone I thought "I'll have them for this" & set about phoning public health. Being in the trade I thought this would be easy, but no! No one in the hospital knew how to get hold of them (can you think of a better job to have!) so in desperation I phoned NHS direct. They were very helpful, kept me on the phone for 30 minutes sounding very concerned & told me they would find the number & phone me back straight away. After 2 hours I got impatient & finally discovered that you had to phone them via the Great Western Ambulance service (work that one out)!!

When I finally got through it was straight to a consultant who said "my God I eat there- I'll have it inspected immediately!" and, feeling satisfied, I hung up & forgot about it.

Eight hours later, the phone rings - "This is NHS direct, just to let you know that we can't find out how to contact public health.....":ugh:

http://farm1.static.flickr.com/164/366518215_c3aac66ef6_m.jpg

[Crashlight]

On a commercial flight from KS to Dallas @ 32K it felt like someone stuck a hot needle in my forehead right above my right eye. I've had nearly a dozen broken bones, burns, concussion, stitches etc... and this TOOK my BREATH away. I went to the restroom to see if a vein had blown in my eye or if I had a bruise where it had popped under the skin. Had never heard of "barotrauma" and was glad to get an answer because I was a little freaked (my younger sister just had a stroke).

[Loose rivets]

Do a search of Loose rivets - this forum - Any date - and put in salt as the search word, you should find a lot about the after treatment and pressure relief that saline solution can give.

It describes hanging upside down with a head full of sterile salty water, and forcing it into the cavities. This has saved my bacon on a couple of occasions where the antibiotic was subduing the infection, but not really clearing the passages.

Just edit to say, I stormed out of a very good job once after more pain than I could handle. Fine on the ground, in agony in the air - only to be fine once I landed again. They just never let people get better before pressuring them to fly, and I will never forget just how much it hurt.

[Enji]

Old topic - however I'm due to fly in 11 days. All my life, i've never had any problems with flying but about 4 months ago, 6 out of the 8 flights I was on I experienced this pain. Half of these flights were seperated by a month. I won't go into the pain since it seems to be covered well enough on here - though I will say the first time I experienced it I thought my head was going to explode.

I want to be a pilot in the future and the fact that I had absolutely no problems at all until a few months ago makes me think something is getting worse. I've had dodgy sinuses for a few years which I think came on around the time I went abroad for a few months (could it be because of sleeping under the air conditioning there?)., although I'm not so sure. Either way, my left nasal passage feels like something is flapping around inside all too often - like a permanent bogey (sorry!) - and one of the passages is completely blocked. I say one because, the weird thing is, it changes throughout the day. Currently as I write, it's the left one that I can't breath in/out.

Anyway, I went to the doctors in the UK as soon as I got back from my trip a few months ago, though I'm still waiting for the ENT appointment to come through the post. Looks like I won't get it in time for flying anyway. No doubt this 'thing' will come to haunt me during descent on all of the flights - though this time it is only 4 flights.

I'm certainly not looking forward to it - and I love flying. I'll try some of the suggestions posted here, though if anyone else has methods that have worked, I'd love to hear them!

[Pontius Navigator]

due to fly in 11 days. . . . the pain . . .my head was going to explode.
. . .dodgy sinuses for a few years

. . . went to the doctors in the UK . . .still waiting for the ENT appointment

. . . I'll try some of the suggestions posted here, though if anyone else has methods that have worked, I'd love to hear them!

You are now under medical supervision and it would be extremely foolish to attempt any self-help cures suggested on a rumour forum.

OTOH learning more about the physiology will not hurt you.

Just keep taking the pills and let ENT do the bizz.

[Bill2]

Ok Folks, I have also experienced the same symptoms along with the same excruciating pain that goes with this 'Baratrama'. It is real, and it hurts beyond belief! You feel like your head is going to explode! I just flew from ATL to BOS this last week, but feared this would happen again, so this is what I did to eliminate this problem. I used a simple home ear wax removal kit to ascertain that I had no build up of wax in my ears, then I checked with a pharmacist that was completely aware of Baratrama, and he told me that was the right thing to do and along with it, you need to take 1 Sudafed tablet. I did just that and yes, this cured the problem we have all spoke about here! See, whether we want to admit it or not, either you have major sinus problems (in which I have never had ever!), or you produce more wax in your ears than you realize. I have always known that I do produce (for whatever reason...lol), more ear wax than the normal person and I had a feeling that was a major contributor and it sure was! See, when your in the plane and gaining altitude on take off, the pressure is going in your eustachian tubes and sinuses and you can easily handle it going in like everyone has spoken of here, but on the decent, all that pressure has to come out and if you have major build up of wax, it is usually thick and gunky and can easily block the tubes and not allow the pressure to escape as it should naturally as you swallow or move your jaw forward like everyone else (almost like blocking it with gum...). Same thing applies if you have (naturally) major sinus issues or blockage, it can create the same effect. But if you are not sure if it might be your sinus area or wax buildup, just do both of these things like I did and you will now fly FREE OF PAIN...it works wonderfully!! Just write to me if anyone needs more details of how to use the ear wax kit...I do it a little different than what the directions say, but I always get nice big chunks of wax out and now do it aprox twice a year to ascertain I will always keep my ears free of any future wax build up! Just want to thank everyone hear for posting this forum....like most of you, I thought it was unique to me, but so happy to hear many, many folks have the same issue!! Happy Flying!

[sevenstrokeroll]

dear suffering man:

one...spend the mone and see at least three doctors on the subject

two...keep a log book and see if you can find other factors as you may have HAY FEVER or ALLERGIES...

three...find a book called: sinus survival

I am a pilot...terrible time living in the eastern US as I had many allergies...ended up taking weekly allergy shots (injections) and it helped a great deal.

AFRIN nasal mist should be on your person if possible for all flights in case of emergencies...but beware the rebound effect which will make things worse in the future.

also, try very long hot showers to allow some relief from swelling of the nasal passages.

I had to consult doctors in Boston, San francisco, and Washington DC before I found my cure.

Good luck...are you French?

[Pontius Navigator]

Bill2 is confusing buildup of wax in the ear and otitic barotrauma which affects the eustasian tubes. Read Extreme pain in forehead during descent/landing - Page 2 - PPRuNe Forums (http://www.pprune.org/showthread.php?t=310037&goto=newpost) more here.


Wax forms in the outer ear which is separated in healthy ears from the middle ear by the tympanic membrane.

The barotrauma affects both the inner ear and the sinuses and sudafed may help relieve the inflamation of the eustasian tubes. The better solution however is DO NOT FLY. If you do fly with inflamed eustasian tubes and manage to clear them thus relieving pressure on the tympanic membrane and open up the sinus cavity you will relieve the pain in the short term but risk allowing infection in to the sinuses and the middle ear. This might need anti-biotics to clear up and could affect your flying for days or even weeks.

What wax might do in the CLIMB is to allow a build up of pressure in the outer ear while the pressure in the inner ear drops with the drop in air pressure. In the descent the outer ear will have eventually equalised with the lower pressure but there will be a natural increase in pressure in the middle ear. This is the reverse process from the blocked eustasian tubes. While it can be painful it is less likely to result in a barotrauma. You will still suffer from cloth ears though.

Another less frequent condition occurs if you have been breathing pure oxygen. The air in the inner ear is displaced by oxygen which is more easily absorbed in to the blood stream. After flight the oxygen continues to be absorbed thus reducing the pressure and creating pain in the ear. This condition may be relieved by drinking beer, talking in the bar, or other oral exercises.

[DX Wombat]

Whatever you do, please DO NOT slosh anything around your nose and sinuses as you run the risk of introducing infection which can be very difficult to get rid of and can, in rare cases, eventually cause meningitis or a particularly evil problem called Lateral Sinus Thrombosis. If you are under the care of a doctor for ANY condition please do not try, or use any form of Folk Remedy without consulting him or her first.
It may be a good idea to ask your GP to do your IgE levels for Dustmite which can cause chronic inflammation of the nasal mucosa.

[Pontius Navigator]

Wombat, quite right. Self-medication can worsen the condition.

GP-wise it is vital that you find one that understands aviation medicine as well. I was once prescribed nasal drops to be applied by tipping my head back and using a pipette to put drops down each nostril.

My barotrauma would have occured in an unpressurised aircraft in a high speed descent from high level. Aside from the risk of hypoxia had I removed my oxygen mask there would have been a loose article risk with my holding bottle in one hand and pipette in the other. Finally, with a helmet it would have been impossible to tilt my head back.

I was cleared to fly but the Doc was so ignorant of aviation medicine, and this on a flying unit, that I refused to fly.

For a passenger, if you get a sudden onset of ear ache man up and call the flight attendants. They may offer a decongestant and request the captain, as a medical emergency, to ease the rate of descent.

The bottom line remains DO NOT FLY.

[ALTSELGREEN]

Interesting discussion- Been flying professionally for 20 years and for the past 15 on long haul. I have always suffered with sensitive ears, but over the past couple of years, have been suffering sporadic bouts of sinus trouble when flying.
Sometimes this can, perhaps be attributed to going in to work when one shouldn't (cold symptoms) etc, but not always. I had a particularly bad episode at the beginning of the year, saw my gp who prescribed antibiotics and a week off flying. I went back to work after this, thinking that I had recovered and all was reasonably well for a few months with only minor discomfort. I was also suffering from a buildup of mucous, which was causing me to continually throat scrape-unpleasant and annoying, especially for the wife!!
I then experienced another episode (Frontal sinus pain - pressure in the face - blocked ears and that horrible fuzzy headed feeling that is associated with sinus complaints). I thought I had inner ear issues (see other thread) but eventually this was ruled out as simply sinusitis symptoms. Back to the GP- more antibiotics and otrivine, none of which worked. I felt as though I had a permanent cold. I ended up sick for more than three weeks, the result of which was a temporarily unfit letter from the CAA, stating that they require me to be fully recovered and symptom free before considering giving me back my medical.
That was three months ago. My GP referred me to an ENT consultant with a particular interest in aviation related issues . I had a CT scan and nasal endoscopy which revealed abnormal (but not bad) structure to my left maxilliary sinus and a narrowing to the opening to my left frontal sinus. The nasal endoscopy revealed significant mucosal swelling and inflammation. I had allergy testing which came back negative to all the main culprits. Diagnosis at this stage
was chronic rhinosinusitis.
Although surgical intervention was discussed, my ENT was keen to avoid this if possible and prescribed a 6 week course of steroid nasal drops to try and reduce the swelling to the mucosa. Things appeared to progress reasonably well, until I caught a common cold which took things back to square one at the end of the 6 weeks.
The consultant then referred me to another specialist for a second opinion.
I was given a very detailed endoscopic examination. He decided that I should try a course of Pulmicort (common asthma treatment) administered to my nasal and sinus passages via a Neilmed sinus rinse kit, in the hope that this delivery system would get to the problem areas unlike simple drops and sprays. I am due to see him again in 3 weeks to acertain if this has worked. He has also suggested that I may be a candidate for balloon sunusplasty, to open up the left frontal sinus opening.
This is all very frustrating, I remain grounded until a satisfactory report on my condition can be provided to the CAA. I am feeling better, with the current course of treatment and am hopeful that things will have settled down by my next appointment.
Problems of this nature should be taken very seriously, I for one will never operate with the hint of a cold. When or if I'm allowed back!
:ugh:

[Pontius Navigator]

This is pretty much what I have been saying and might have happened to me. If you have a bad head cold you risk sinusitis. Once the tubes are blocked it is too easy to get germs in when you descend and the pressure increases.

[ALTSELGREEN]

Well the steroid treatment has failed and now I am scheduled for balloon sinuplasty and turbinate reduction surgery. Fingers crossed that this will help to solve these issues once and for all:ugh:

[Loose rivets]

I'm sure I said somewhere in my hanging upside down post, to use sterile water to make the saline mix.


The trouble is, this problem causes so much pain it's hard to endure, and I was on my third antibiotic with no results. I learned it was notoriously difficult to treat some sinus infections and I simply had to resort to my own methods.

The relief was almost instant once that ticking creaking noise started. When the tick tick tick happened on the first side, the pain disappeared on that side only. I'd say that was a strong indicator of the localized effect of pressure equalization.

I would protest that this is by no means a folk remedy. Saline nose douche devices were sold by Boots for most of my life. But then, after a week, I'd have taken treatment from a bloke dancing around a fire with a bone in his nose.

Tilting head back? No use at all. Damn nigh on upside down is required, and if anything tilting forwards if complete inversion is impossible. But hey, in an aircraft . . .

[safelife]

Interesting to read that others suffered the exactly same symptoms as myself. I had these pains for about three months a year ago, and nothing seemed to help.
In my case it seems to be somewhat related to hay feaver and food allergy, a combination of them plus a slight cold or alcohol which can worsen the condition steeply (by releasing histamine).
I managed to finally escape this hell by coming aware of my food allergies (yes, plural), limit alcohol intake to a minimal amount and finally taking a pill of Cetirizine about 8-12 hours before flight.
Especially the latter seemed quite effective to me as it blocks the effects of histamine in the body, which is a major cause for the swellings.

Good luck to everyone who's affected. I became fine some weeks later and the trouble never returned even with a mild cold.

[safelife]

Just noticed that in other countries Cetirizine is sold under the name Zyrtec or Reactine. I think it's well worth a try especially as it has little to no side affects. It's available without prescription in most countries.

[Bearcat]

Suffered sinus's for years, ended up an afrin junkie.....never pain but it felt like someone left a rock in my nasal cavity such it weighed me down and utterly blocked in one cavity. In for a job next month, septoplasty, Fess, rhinoplasty too to straightened my nose......didn't duck quick enough in an altercation years ago.

[Aussie25]

I am writing this post on the aircraft and will be descending in a few minutes.

Over the last 10 years, I would get an excruciating ice pick pain in my forehead over one or the other eye. It was at my very limits to endure, clenching my fist and gritting my teeth.

Touching my forehead during this, just made it worse. So I would just sit there.

And it wouldn't happen every time. It seemed to be dependent on the speed of the re-pressurisation and the altitude the aircraft had been pressurised to.

Though sore afterwards, the pain would eventually dissipate as we neared sea level; I have an altimeter watch so it's easy to see what the plane is pressurised to and how quickly they re-pressurise it.

The most reliable solution has been a topical anti-inflammatant, oxymetazoline 0.5% applied liberally before repressurisation begins. One to two squirts in each nostril and inhale to bring it into the sinuses.

We've begun our descent as I finish this post. Wish me luck.

[Radgirl]

Jesus Aussie25, shouldnt you be looking out of the cockpit window, pulling or pushing the joystick and flicking switches when flying as opposed to posting on here? Glad I am not one of your passengers mate!

[Pontius Navigator]

Aussie, it sounds as if you are experiencing Sinus Baratrauma. As I recall, there is a cavity in the head which has a drain hole. If you were an animal this hole would be at the front lowest point in relation to walking head down on all fours. It is in the same position in human or front higher position. This means mucus and the like can pool rather than drain. If the holes become blocked then you will experience pain.

What might help is to bend and get your head down as far as possible. Other than that, read up, see if it fits your pain, then discuss with your doctor.

In my case the holes are free draining. When I have been swimming, bending over water pours out!

[Loose rivets]

My memory seems to be functioning okay, because almost word for word what I was going to say before noticing the date, I'd already said - but forgotten to look at the date.:p


We fiddled the pressurization and stayed two k down from normal cruise but when we had to climb due to fuel, I was totally incapacitated. When we landed I was fine, but the memory of that pain made me scrumple up my new roster and walk away from serious flying for many years. It was all down to being pressured to fly while sick with colds. The crews were dropping like flies, but still crewing put on the pressure.

It's over 40 years ago, but the memory of the pain is like yesterday.


Don't muddle it with the eustachian tube or inner ear issues.

Infecting the entrance to the cavity by douching? It's probably already infected, and with a very poor prognosis for antibiotics helping - unless there have been some new findings. The use of anti-inflammatory drugs seems to be what they're doing these days. I'm glad to hear it's being recognised and treated aggressively.

The Geoffrey Wellum (age 96!) in First Light was suffering terribly in Malta and eventually needed surgical treatment back home. Doubtful even he would have been given the few drops of penicillin they had back then. I thought it odd they stopped him swimming, though it hadn't helped by then.

[Pontius Navigator]

LR, we are of an age. I seem to remember the solution for persistent SB was to drill out the holes to make them larger.

[Danny42C]

Year 1952, place Central Medical Board (Kelvin House). Full aircrew medical for Limited P.C. as GD Pilot. Radiographer notes spot on lung - get him into Wroughton to check it out. ENT man at Wroughton gets in on the act: says: "your sinuses are bunged up" !

"But they can't be, have just been flying (unpressurised) Meteor T7 to FL350, no trouble up or down?" - "Don't argue ! If I say they're bunged up, they're bunged up !" Cannula pushed up snout. hosed out, repeat ad lib. for a few days. No better, bilateral radical antroscopy (reamer holes out), Face swells up like a balloon for a couple of weeks, no ill effects. ENT man happy - job done !

That, I suggest, is the only real, permanent answer.

(The spot ? - bronchosopy (not a bundle of laughs): it's bronchiectasis (irreversible). Could be fixed surgically [excise affected bit], but would cost RAF Arm+Leg as job outsourced to King's surgeon, and we don't need pilots all that much [King died ! - so just as well, perhaps].

First restricted to 10,000 ft for a couple of years, then chop (ATC for 17 years). Spot no bigger today. Ah, well, c'est la vie).

[Pontius Navigator]

Danny, thank you for the detail. Is that still a procedure today or dko they assume no one fly's above 8,000 feet.

Your grounding of course was why so many aircrew did everything in their power to avoid the quacks.

[gingernut]

=>90 min. before takeoff 1 sudafed pill for anti-swolling

I'd be cautious about this. Discuss with your aviation Doc, and beware the of "the rebound."

[Pontius Navigator]

Agree with gingernut. The problem with knowingly flying with a blocked sinus cavity or eustachian tubes is that in the descent gunge can be forced in to the cavities if you manage to clear them.

You only need the decongestant if you experience pain when you didn't know they were blocked. In the case mentioned by Danny, the naturally small sinus entry holes can be ordinarily blocked by health mucus and reaming out will effect a permanent cure. This procedure is available on the NHS If your symptoms don't improve despite trying the treatments mentioned above, a type of surgery called functional endoscopic sinus surgery (FESS) may be recommended. This is a procedure to improve the drainage of mucus from your sinuses.