Sphenoidal Sinus Porblems

[Gordo]

Howdy,

A mate of mine blew his sphenoidal sinus (spelling?) about 10 years ago and has not dived since. His diving medico at the time told him that he could probably dive, but the chances were that it would blow again, but next time it would be worse.

He has often said the pain he experienced was the worst he could ever imagine so understandably he has sold all his dive gear and given the game away.

I have recently been reading about Closed Circuit Rebreathers. I understand they greatly increase the limits for non-deco dives.

So the question is this: Does a CC Rebreater allow you to breath air at "normal" pressures, and if so.......is that going to allow my mate to get back into diving (given the appropriate gear and training etc)

In short, will the rebreather reduce the risk of his sphenoidal sinus blowing again.

Any medical options out there??

Thanks.


Gordo

 

[BillP]

Hi Gordo:

I don't think using a rebreather would help your buddy. Even divers using rebreathers get their breathing gas at ambient pressure- whatever the pressure is in the surrounding water. Your buddy would still have to equalize. (All types of u/w breathing apparatus deliver gas at ambient pressure. If your breathing gas isn't delivered at very close to ambient pressure, you can't breathe.)

You can read more about sinus barotrauma at:

http://www.scuba-doc.com/otherent.htm

and a search of DAN reveals a lot of info at:

http://www.diversalertnetwork.org/search/results.asp?q1=sinus&ct=DANnonmed,DANmedical

HTH,

Bill

(If a diver can't equalize, I suppose they could look into 1 atmosphere dive suits like those illustrated below! -grin)

http://www.popsci.com/science/01/09/17/abyss/index2.html

http://divermag.com/archives/sept99/phil_sep99.html

 

[scubadoc]

BillP is completely on target! The only way to dive without changing pressures is to get into a robot-like apparatus or a diving bell that will allow for 1 ATA (surface) pressures and protection from the tremendous surrounding pressures of depth.

The other alternative would be to seek a second opinion in regard to the possibility of finding some correctible abnormality obstructing the easy passage of gases in and out of the sphenoidal sinuses. Sphenoids are rarely affected by barotrauma (it's mostly the frontals in that area) but when it happens, there is the danger of gas getting into the cranial vault and infection.

Best regards and good things!
Ern Campbell, MD
Diving Medicine Online
http://www.scuba-doc.com

 

[The Iceni]

While not making any recommendations whatsoever I wonder just what permanent damage your mate may have caused to himself.

I suspect when his sinus "blew" he may have caused the production of a permanent fistula, or indeed an enlargment of the anatomical foramen in which case I suspect that he may not now have any problems whatsoever with the equalisation of that sinus. Whether it would be wise for him now to allow "dirty" water to enter the sphenoid so easliy with the consequential risks of infection is another matter.

- On the other hand it is also theoretically quite possible that the inflammation around the site of gas egress from the sinus itself (caused by the considerable physical trauma) could worsen the problem by effectivelly isolating that sinus from ambient pressure in the longer term by the formation of scar tissue and/or a consequential stenosis of the anatomical foramen.

In my humble opinion there is really only one way for him to find out and that is for him to seek ENT specialist medical investigation, perhaps with an MRI or alternative imaging to determine the extent of the damage and only then, perhaps, for him to experiment with diving to shallow depths at first.