Inflammatory Modifications in Paranasal Sinuses and Ostiomeatal Complex Anatomical Variations in Jet Aircraft Pilots: A Computed Tomography Study

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Introduction Jet aircraft pilots are exposed to huge pressure variation during flight, which affect physiological functions as systems, such as the respiratory system.

Objectives The objective of the present investigation was to evaluate inflammatory changes of paranasal sinuses of jet aircraft pilots before and after a jet aircraft training program, using multislice computed tomography (CT), in comparison with a group of nonairborne individuals with the same age, sex, and physical health conditions. A second objective of the present study was to assess the association between the ostiomeatal complex obstruction and its anatomical variations.

Methods The study group consisted of 15 jet aircraft pilots participating in the training program. The control group consisted of 41 nonairborne young adults. The 15 fighter pilots were evaluated before initiating the training program and after their final approval for the presence of inflammatory paranasal sinus disease. The ostiomeatal complex anatomical variations and obstructions were analyzed in pilots after the training program.

Results Jet aircraft pilots presented higher incidence of mucosal thickening in maxillary sinus and anterior ethmoid cells than controls. Prominent ethmoidal bulla showed significant association with obstruction of the osteomeatal complex.

Conclusions Jet aircraft pilots present increased inflammatory disease when compared with nonairborne individuals. The presence of a prominent ethmoidal bulla is associated with ostiomeatal complex obstruction.

Keywords multidetector computed tomography - diagnostic imaging - maxillary sinus - aerospace medicine - aviation Author Contributions

All authors contributed to the study conception and design. Silva Y. performed the first draft of the manuscript, project development, data collection and manuscript writing; Munhoz L. performed the data analysis, manuscript writing and editing; Teng E. performed the first draft of the manuscript, manuscript writing and editing, data analysis; Billaqui E., performed the first draft of the manuscript, manuscript writing and editing, data analysis; Rosa C. performed the first draft of the manuscript, manuscript writing and editing, data analysis; Arita E. performed the project development, data analysis, final review of the manuscript; Castro C, performed the project development and protocol development. All authors read and approved the final manuscript.


Ethical Approval

Approval was obtained at Ethics Committee of São Paulo University Medical School - São Paulo (number 315/15).


Informed Consent

All patients signed and approved the appropriate informed consent for the present study.


Financial and Non-financial Interests

Authors declare no financial and non-financial interests.

Publication History

Received: 13 January 2023

Accepted: 28 May 2023

Article published online:
29 November 2023

© 2023. Fundação Otorrinolaringologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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