![]() ![]() Headache attributed to airplane travel, also named "airplane headache" (AH) occurs in a population of passengers during airplane travels. These studies would advance our understanding of AH pathogenesis and potential use of treatments that are not yet established. Conclusionsīased on this systematic review, further studies seem required to investigate underlying mechanisms in AH and also to investigate the biological effects of nonsteroidal anti-inflammatory drugs and triptans for alleviating of AH. Nonsteroidal anti-inflammatory drugs and triptans have been taken by passengers with AH, to relieve the headache. Sinus barotrauma has been considered as the main cause of AH. The pain is unilateral and localized in the fronto-orbital region. The headache presents as a severe painful headache that often disappears within 30 min. Main findings revealed that AH attacks are clinically stereotyped and appear mostly during landing phases. This systematic review included 39 papers. The search yielded 220 papers and the papers were sorted based on inclusion and exclusion criteria established for this study. The systematic literature search was performed in 3 relevant medical databases PubMed, Scopus, and Embase. This systematic review was performed to facilitate identification of the existing literature on AH in order to discuss the current evidence and areas that remain to be investigated in AH. Today, there are still uncertainties about the pathophysiology and treatment of AH. Aircrew that suffer Stage III aerosinusitis are at risk for recurrent sinus barotrauma that may require an expertly performed functional endoscopic sinus surgery to successfully manage it.Headache attributed to airplane travel, also named "airplane headache" (AH) is a headache that occurs during take-off and landing. Stage III lesions are rarely seen in civilian air travelers due to the relatively low fluctuations in ambient air pressure. Additionally, antihistamines are reserved for cases where allergies were the inciting cause. Use of antibiotics is reserved for those cases initiated by bacterial sinusitis. Stage I or II lesions are generally treated conservatively with a 1-wk course of topical sprays, analgesics, a tapering course of steroids, and oral decongestants. ![]() Management of this condition is based on the Weissman stage. Categorization of the patient into the Weissman classification is important for determining prognostic factors for recovery. Evaluation of the patient presenting with aerosinusitis consists of a careful physical exam with emphasis on diagnosing treatable nasal and sinus pathology. Prophylaxis of this condition consists of an oral decongestant before flight and nasal decongestant spray during the flight just prior to descent. Patients presenting before flight with an upper respiratory infection are at risk for aerosinusitis. Endoscopic surgery to expand the natural drainage pathways of the affected sinuses with minimal surgical trauma to the healthy mucous membranes is largely successful. In part 2, diagnostic measures, drug therapy, balloon dilatation and endoscopic sinus surgery are presented, along with a discussion regarding when flight attendants and pilots are able to resume their work. Additionally, currently available monographs and further articles that could be identified based on the publication reviews were also included. ![]() This Continuing Medical Education (CME) article is based on selective literature searches of the PubMed database (search terms: "aerosinusitis", "barosinusitis", "barotrauma" AND "sinus", "barotrauma" AND "sinusitis", "sinusitis" AND "flying" OR "aviator"). Sinonasal diseases and anatomic variations leading to obstruction of paranasal sinus ventilation favor the development of aerosinusitis. Aerosinusitis more frequently affects the frontal sinus than the maxillary sinus and mostly occurs during descent. ![]()
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