![]() It is thus above all at this point that the intra-sinus pressure will become unbearable. ![]() Made up of several bony walls in the skull, it has points of weakness. The most fragile point is the nasofrontal canal which connects the frontal sinuses with this middle meatus and is located at the internal angle of the eye. These sinuses drain into the nasal cavity at the level of the middle meatus, under the middle turbinate. The anterior sinus complex consists of the frontal sinuses, the maxillary sinuses and the anterior ethmoidal cells. The more the diver goes up, the more the pain is intense because the air, trapped, will want, at any cost, to go out of the closed cavity – because there is an ineluctable expansion of the air in this indeformable cavity – creating an intense pain, with an explosion sensation in the head. The sinus pressure at 20 meters for example is 3 bars. The pain is intense, very quickly syncopal, blocking the ascent of the diver who is however required to go up but who cannot. Let us specify that the sinus barotrauma occurs moreover preferentially at the ascent, contrary to the barotraumatic otitis which occurs specifically at the descent. The diver has made his dive normally and the pain appears on the way back up. On the other hand, the problem is quite different. The consequences here are not serious because the diver who feels these symptoms stops his dive and goes back up. ĭuring descent, as well as during ascent, if the ostium of a sinus (especially a maxillary sinus under the orbits or a frontal sinus) is blocked by mucus or nasal polyps, equipressure with the outside environment may not be possible.Ī depression that increases in a closed sinus cavity creates a depression that, if it worsens, will cause a tear in the endosinus mucosa, with more or less sharp pain and epistaxis. The pressure variations in these cavities correspond to the Boyle-Mariotte law. Much more serious and the only one that prevails, in fact, in the diver is the sinus barotrauma. In humans, the sinuses are closed or half-closed cavities filled with air. Back home, he can consult his ENT specialist, who will perform a cauterization of the vascular spots, a cauterization whose effect is generally not definitive but will leave him alone for a while. This maneuver, aggravated by local irritating factors, such as salt water, can encourage these repeated epistaxis, which are not serious except for the fact that they make the diver uncomfortable. This fragile vascular spot is attacked during descent, during the repeated Frenzel or Valsalva maneuvers, when the nose is pinched more or less strongly between the thumb and the index finger to balance. ![]() On the front part of the nasal septum, there is a highly vascularized area called a vascular spot Sometimes it is the people around him who point out this blood in the mask. There are no other symptoms and this phenomenon is frequent, especially in the same diver who does not worry about it. The diver gets out of the water and notices blood in his mask. The simple epistaxis is banal, asymptomatic. When diving, one can be confronted with two very different clinical pictures of epistaxis : simple epistaxis and sinus barotrauma. Hemoptysis is a sign of bleeding from the airways, particularly the lungs (pulmonary overpressure is frequently accompanied by hemoptysis). As you can see, the diagnosis is easy at first glance. Hematemesis is a sign of digestive bleeding, which, if it is abundant or low-lying, will be accompanied by a melena (black digested blood, emitted by the stool, malodorous).Įmission of bright red, foamy, aerated blood, externalized through the mouth during coughing effort. In case of heavy bleeding or posterior epistaxis, swallowed epistaxis may be associated with oral bleeding. Epistaxis can be differentiated from :Įmission of red or brownish blood from the mouth, during vomiting efforts. Epistaxis may be accompanied by fronto-orbital pain. An epistaxis is a spontaneous discharge of blood from the nose.
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