Aerosinusitis is when you feel discomfort or pain in your sinuses because they can’t adjust to pressure changes during activities like diving or flying.

If you have ever felt discomfort or noticed nosebleeds during a flight or while scuba diving, you may have experienced aerosinusitis.

Knowing what the symptoms are and how to prevent them can help you feel better, even when pressures change.

Aerosinusitis — also known as sinus squeeze, barosinusitis, or barotrauma — happens when the lining of your sinuses gets irritated because the pressure inside them doesn’t match the pressure outside in the air.

This can happen during scuba diving, flights, or hyperbaric treatments (exposing the body to high atmospheric pressure in a specially designed chamber).

Pain — particularly in the frontal sinuses — is the most common symptom. Pain can sometimes lead to tooth pain when the maxillary sinuses are affected.

Other symptoms include nosebleeds, watery eyes, and a runny nose.

In a 2017 research review, researchers suggest that barosinusitis can be categorized into three subtypes:

  • Acute, isolated barosinusitis: This refers to a sudden and isolated episode of barosinusitis. It typically occurs when there is a rapid change in ambient pressure, such as during air travel or diving. Symptoms are usually short-lived and resolve once pressure equalizes.
  • Recurrent acute barosinusitis: This subtype involves repeated episodes of acute barosinusitis. Anyone with this form may have symptoms like facial pain and pressure during each exposure to pressure changes. These symptoms often come back when pressure changes happen again.
  • Chronic barosinusitis: Chronic barosinusitis is characterized by persistent and long lasting symptoms related to pressure changes. While recurrent acute barosinusitis involves separate acute episodes, symptoms of chronic barosinusitis may be ongoing and not limited to specific pressure changes.

Is aerosinusitis common?

Aerosinusitis is not common in everyday situations. It typically occurs during activities where you experience rapid changes in pressure — like scuba diving, flying, or hyperbaric oxygen treatments.

It’s estimated that aerosinusitis happens in about 34% of divers and 20–25% of pilots. Commercial pilots tend to experience it more frequently than high-performance pilots, like fighter pilots.

Some evidence suggests that in 50–73% of aerosinusitis cases, people also had an ongoing upper respiratory tract infection (URTI).

Common signs and symptoms of aerosinusitis may include:

  • nasal and forehead pain or discomfort, possibly with a toothache
  • watery eyes
  • runny nose
  • nosebleeds or bloody discharge
  • inflammation or redness
  • thickening of the sinus lining
  • small growths or lumps
  • presence of tiny blister-like structures

What does aerosinusitis feel like?

Aerosinusitis can feel like pain, pressure, or discomfort in your sinuses, typically around your forehead.

It might be accompanied by symptoms like a runny or bloody nose, teary eyes, or even toothache-like pain if the maxillary sinuses are involved.

In most cases, aerosinusitis symptoms resolve within a few hours to a few days after the event that caused it (such as flying at high altitudes) has ended. However, duration may depend on the type:

  • Acute isolated aerosinusitis: Symptoms typically resolve within hours to a day after pressure equalization.
  • Recurrent acute aerosinusitis: Each episode’s duration is similar to acute isolated aerosinusitis, resolving after pressure equalization.
  • Chronic aerosinusitis: Symptoms in this form can last for weeks to months and may recur regularly.

Can aerosinusitis cause death?

Aerosinusitis is not life threatening on its own.

However, if aerosinusitis symptoms are severe or not properly managed, it may be dangerous. It can potentially lead to complications or contribute to accidents — especially in situations where pressure changes are critical, such as in aviation or diving.

When to see a doctor

Reach out to a doctor if you have persistent or severe symptoms or if your aerosinusitis doesn’t improve with home treatments.

If you’re an aviator or diver, seeking medical attention is crucial when aerosinusitis symptoms affect your performance or safety.

Treatments vary based on the type and severity of aerosinusitis. Here are some common options:

In a 2018 study, surgery was explored as a solution for aviators with refractory aerosinusitis. The surgery emphasized symptom relief over full disease resolution. Results were positive, allowing all aviators to resume flight duty.

How to help prevent aerosinusitis

To help prevent aerosinusitis:

  • Avoid diving when you have an ongoing upper respiratory infection or active allergic rhinitis.
  • Prevent aerosinusitis by using prophylactic oral decongestants like oxymetazoline spray, pseudoephedrine, and topical intranasal glucocorticoids.

Aerosinusitis, or sinus squeeze, is characterized by an inability to equalize pressure between your sinus cavities and your surrounding environment. It can result in discomfort and pain, particularly in situations involving rapid changes in pressure.

For anyone in professions like aviation or diving, addressing aerosinusitis is crucial for your well-being, career, and safety. If you’re having persistent symptoms, consider reaching out to a healthcare professional for prevention and treatment options.