Artikel
Medical and Surgical Treatment in Divers with Chronic Rhinosinusitis and Paranasal Sinus Barotrauma
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Veröffentlicht: | 3. August 2011 |
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Gliederung
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Introduction: Divers with chronic Rhinosinusitis (CRS) are predisposed to developing paranasal sinus barotrauma (PSB). The aim of this study was to systematically follow-up such a patients’ collective after medical or surgical treatment of CRS in order to evaluate the safety of diving.
Methods: We conducted a retrospective, cross-sectional, descriptive study, in which we included 82 adult divers. Treatment implied a five day course of a systemic steroid and a six week course of saline nasal irrigations and topical nasal steroid with mometasone in maximal dosage. If symptoms persisted functional endoscopic sinus surgery (FESS) was performed. Questionnaires included the Sinonasal Outcome Test-20 German Adapted Version (SNOT-20 GAV), Dive Related Questions (DRQ) and general questions.
Results: Forty of 82 divers completed the questionnaires with a mean follow-up of 42 months. There was a statistically significant improvement of the Total Score (TS) and of every subscore, except the General Quality of Life score, in the SNOT-20 GAV as well as of the TS in the DRQ. Before treatment, divers who required surgery reported significantly more symptoms than divers who were treated conservatively. Post treatment there were no significant differences between the medical and surgical group.
Conclusions: Divers with sinus problems can successfully be managed medically and if conservative treatment fails, FESS provides a statistically significant improvement of symptoms. Complications in diving after both treatment modalities were not observed.