Sinus Pain

[bboy]

a couple of months ago i experienced severe frontal sinus pain on descent, leading to a bloody eardrum.
Ended up on the operating table, getting stuff jamed up my nose, and cost me a fortune.
Thing is, Im not sure if it was required as ive heard its something that happens, albeit seldomly ,by a lot of pilots.
Has anyone had the same thing happen??

[FireDragon]

bboy

You were lucky you didn't fracture your eardrum(s) - did you fly knowing you had a cold / flu / sinus problems?

One chap I know who did this ended up not being able to fly for 10 months after blowing an eardrum.

To round up: NEVER fly with any of the above, and always make sure you can 'pop' your ears if you are at all unsure

[Bing]

I have had sinuspain a couple of times during descent in pressurized aircrafts. Hurt like hell, and it was hard to just sit quietly in my seat, not freaking out. I'm just a passenger, and I can't imagine how I could have landed a plane, if I had been a pilot with this happening. Luckily I didn't blow a eardrum or something. Two questions: would this condition be worse in a light, nonpressurized aircraft, or would it be the same? Second, does anyone know of a nasal spray or something that would prevent this painful event (insted of not flying)?

Thanks.

[This message has been edited by Bing (edited 15 January 2001).]

[Dave Incognito]

Had severe sinus trouble once when on a solo CPL nav. Went and got it checked up with an aviation doctor who then sent me off to have a CAT scan. It showed that my sinus opening were quite small. Apparently this is a fairly common problem but is generally only a problem with flight crew and divers. I then had an operation to correct the problem and now it all seems to be working fine (however the whole process left me on the ground for over 2 months and wasn’t entirely pleasant).

Bing

The best nasal spray I’ve come across is Beconase. Doesn’t make you drowsy etc. but for memory is only available on prescription.

Have a good one, Dave.


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Flying is easy - just throw yourself at the ground and miss.

[foghorn]

I've had severe sinus pain only once, when I lived in Johannesburg (alt 5,500 ft). I was descending into Cape Town on a commercial flight from Jo-burg as pax. I had no other symptoms of cold, and put it down to my sinuses being 'used' to the high altitude and getting a bit of a surprise by the Sea Level pressure. Don't know how medically correct this conclusion is.


Bing: Unpressurised aircraft can be worse that pressurised aircraft. Although pressurised cabins climb to an equivalent altitude of around the 8,000ft mark, the rate of change is normally limited to a low value (I think it's around 500ft per min). In unpressurised aircraft the rate of change of cabin pressure is often two, three, or even four times this: it obviously directly depends on the aircraft's rate of climb.

Dave Incognito: Although you won't be interested in this being from Oz, UK-based people may want to know that you can buy Beconase sprays over the counter here.

[This message has been edited by foghorn (edited 15 January 2001).]

[Rob_L]

Just for reference, I have a reference in my prescription drugs book: Beconase/Beclomethasone/Beclovent: "may be a disqualification for piloting".

Note this is a US publication "The Essential Guide to Prescription Drugs", 1995 edition. If it could be a problem over there, it might well be here, so best kept quiet. Also like all "cortisone-like" drugs it could have side-effects.

If still in print, this is a very useful book in that it tells you exactly which drugs pose problems with the FAA.

[Dave Incognito]

Rob_L,

The CASA approved aviation specialist assured me that Beconase was approved to take while acting as flight crew. I now carry it with me at all times in my headset bag. However, I do not doubt your reference, and will certainly make some further enquiries.

Have a good one, Dave.

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Flying is easy - just throw yourself at the ground and miss.

[bboy]

Dave Incog,
Sounds like you had the same thing as me.

Just one thing. Beconase is a steroid and takes up to 3 weeks of continous use to have effect. Probably no use in flight. This was told to me by a doc. Anybody know anything more???
I carry a saline nasal spray, which is a fancy word for salt water, just in case.
I have had no trouble since my OP, but **** was that painful.

Fire Dragon. No I was'nt aware of any cold or flu. Now i am probably over cautious and ensure that my ears work before flight.


[This message has been edited by bboy (edited 16 January 2001).]

[Bird Strike]

Hi Dave and anyone else interested (in Australia),

Beconase is available without prescription in NSW and QLD (they're 'Pharmacist Only' now). I don't know about anywhere else in Aus though.

Another thing, doesn't nasal spray called Otrivine (sp?) help clear your nose? This is I believe is also Pharmacist Only in Australia. I haven't used it in flight, so I am not sure if it helps with the situation being discussed here, though.

[Dreamer]

In the UK, as far as I'm aware you can get Beconase etc over the counter. The spray a doctor will prescribe is likely to have the same content as a regular hayfever/allergy spray.
I have had a lot of sinus trouble which went on to cause ear problems.
Flying with a cold can be very painful and I don't suggest that anyone does it.
Try asking at the chemist whats best to use.

[mik]

An extract from http://www.aviationmedicine.com/allergies.htm
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Preventive Medication- Nasal Steroids

Another method of prevention is the use of medication to block the body’s reaction the allergens. The most common symptoms of nasal stuffiness are effectively relieved by nasal steroid sprays. These steroids act by stabilizing the cells in the body exposed to allergens so they do not release histamines. They are not immediately effective, but may take several days to weeks to reach their full effect. If someone can anticipate their allergy season, using they agents several weeks before the season starts may block most symptoms. The steroids are usually well tolerated and act on the nose and upper respiratory tract. They are relatively safe for long term use and the FAA will approve their use if they are effective. Reporting their use to the FAA may be done at the airman’s next physical exam. Some of the name brands for these effective products are Beconase, Vancenase, Flonase, Nasalide, Nasacort, Nasonex, Nasarel and Rhinocort.

[Air Conditioned]

The foregoing contains some good advice, but is a bit low-key. If the following (this IS a rumour network) causes alarm it is probably to the good.

I would recommend that no-one who has experienced barotrauma should fly without solid advice from an aeromedical expert to establish the underlying cause, treatment and/or medication to be used. Once finding yourself prone to the event, never get airborne without a squirt bottle of suitable medicine.

I think that Beconase and other steroid based drugs are for long term treatment of a chronic condition. Pilots must have medical clearance for their use, and consideration given to the underlying cause. I don’t believe they will be of any use in an acute situation. For that you need a powerful decongestant that liquefies goo and shrinks the nasal/sinus passages. Otrivin may be one of these, but get medical clearance. (not just pharmacist advice) A name from the past is Neo-synephrine which was extensively recommended. Whether that is/was a trade or medicine name, or if still in vogue, I do not know.

These events must not be taken lightly. Ears can be a source of considerable discomfort, perhaps disabling, but maybe self-limiting since the drum will burst and then the pain probably won’t get any worse. But that may not be the end of it; I know a guy who went through that process in a fighter (fortunately a two-seat trainer) but got over it without apparent ill effect – even loss of hearing. Some 23 years later an event of cholesteatoma disease in that ear may have been life threatening. Maybe coincidental, but apparently a typical cause of this growth. (A recent newspaper article stated that this was the disease that killed Oscar Wilde.)

Sinus pain is the most vile event I have known, and could definitely be incapacitating. I have had a very serious scare, coming close to the limit in a single pilot IFR passenger carrying aircraft. What goes up must come down, and once a sinus blocks it is unlikely to clear without major pain, and if it doesn’t, the owner is going to be in a very bad way. You will probably get relief by climbing, squirting decongestant, and descending at an appropriate rate, clearing ears/sinus continually. Which assumes that you have enough fuel, or are not a passenger in a 747 that may not stop for you. Check this with your aeromedical specialist. If you are prone to such blockages then a routine therapeutic squirt at top of descent may help. Have care though, it has been said that excessive use of these medicines can result in them reversing their action and being of no help at all. More words with the Doc.

Flying with a cold will exacerbate any potential problem or produce one for you. Don’t forget that the air entering your head cavities to equalize pressure will carry with it any goo, sludge and infections from the nasal and throat areas. Should such infections blow up in the cavities it is well to remember how complex and delicate the middle ear is, and that the skull is pretty thin around those areas. Therefore get yourself to medical help pronto if you think you are unwell after an ear/sinus event.

Happy flying.