Boston Andrew G, McMains K Christopher, Chen Philip G, Weitzel Erik K
Department of Otolaryngology-Head & Neck Surgery, San Antonio Military Medical Center, 3551 Roger Brooke Dr, Fort Sam Houston, TX.
ENT Section, South Texas Veterans Health Care System, 7400 Merton Minter, San Antonio, TX.
Mil Med. 2018 Jul 1;183(7-8):e246-e250. doi: 10.1093/milmed/usx222.
For some career military aviators, their ability to continue on flight status is limited by the pressure and pain of aerosinusitis, which is present only while in the flying environment. Failure to treat their disease process can mean the end of their flying careers and the loss of valuable assets trained with taxpayer dollars. Because some medications commonly used in treatment of sinus diseases are not allowed in aviation, this presents a unique problem for their medical management. Surgical treatment must be aimed at treating to symptom relief and not solely disease mitigation. One alternative is operating "beyond the scope of disease" present during a one-atmosphere clinic visit.
A case series of nine career aviators with aerosinusitis treated at one academic military Otolaryngology department in a tertiary care facility. Results from a treatment algorithm that balances symptomatology and staged surgical intervention are reviewed. The primary endpoint was return to flight duty.
For patients treated according to this algorithm, the mean time to return to flight duty was 3.8 mo, requiring an average of 1.2 surgeries. To date, 100% of career aviators have returned to flight duty using this method.
Refractory aerosinusitis represents a potentially career-ending medical condition for the aviator and lost training costs to the taxpayers. Using the treatment algorithm presented, 100% of aviators were able to return to flight duty; a savings of millions of dollars for taxpayers. Future work will focus on modifications to the surgical techniques to reduce the extent of surgery while maintaining satisfactory results. Additional study should be undertaken to assess generalizability of these results in the broader aviation community.
对于一些职业军事飞行员来说，他们继续飞行的能力受到航空性鼻窦炎的压力和疼痛的限制，这种病症仅在飞行环境中出现。未能治疗他们的疾病过程可能意味着他们飞行生涯的结束以及纳税人出资培养的宝贵人才的流失。由于治疗鼻窦疾病常用的一些药物在航空领域不被允许使用，这给他们的医疗管理带来了一个独特的问题。手术治疗必须旨在缓解症状，而不仅仅是减轻疾病。一种选择是在常压门诊就诊时对“超出疾病范围”的部位进行手术。
对一家三级医疗设施中的一个学术性军事耳鼻喉科治疗的9例职业飞行员航空性鼻窦炎病例系列进行研究。回顾了一种平衡症状学和分阶段手术干预的治疗算法的结果。主要终点是恢复飞行任务。
对于按照该算法治疗的患者，恢复飞行任务的平均时间为3.8个月，平均需要1.2次手术。迄今为止，100%的职业飞行员使用这种方法恢复了飞行任务。
难治性航空性鼻窦炎对飞行员来说可能是一种潜在的终结职业生涯的病症，同时也给纳税人造成培训成本的损失。采用所提出的治疗算法，100%的飞行员能够恢复飞行任务，为纳税人节省了数百万美元。未来的工作将集中在改进手术技术，以在保持满意效果的同时减少手术范围。应进行更多研究以评估这些结果在更广泛的航空领域的普遍性。
