Sinus barotrauma (sinus squeeze)

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Barotrauma affecting the sinuses is oftentimes referred to as sinus squeeze. This condition is quite common among divers but can also occur in any conditions which involve rapid descent or ascent where the body could not properly adjust.

An individual can also develop sinus barotrauma while undergoing hyperbaric oxygen therapy for certain medical conditions.

Possible causes of sinus barotrauma

The sinuses are hollow cavities in the face that are filled with air. The pressure in these cavities is usually equal to the ambient pressure but if it abruptly changes and the body could not equalize the pressure in the sinuses, sinus barotrauma can occur that can actually trigger bleeding into the sinuses.

Any obstruction in the sinuses will make it difficult for the body to equalize pressure. Factors such as history of sinus infections, nasal polyps, current sinus or upper respiratory infections, enlarged turbinates and other conditions involving the nasal passageways and sinuses can put an individual at higher risk for develop sinus barotrauma.

Shooting pain in the face or a severe headache are the distinctive indications of sinus barotrauma.

Generally, even though it is not possible to develop sinus barotrauma without an underlying sinus issue, it is unlikely.

What are the symptoms?

It is important to note that the severity of the symptoms usually depends on the severity of sinus barotrauma but shooting pain in the face or a severe headache are the distinctive indications. Other symptoms that can occur include toothache, bloody nose or ear pain. Even though an upper respiratory infection can cause sinus barotrauma, the condition itself can cause upper respiratory infection.


If an individual develops sinus barotrauma, it is an indication of other sinus issues that requires treatment either surgically or with medications such as decongestants, antibiotics or antihistamines. Remember that anyone who experiences sinus barotrauma must be properly assessed by an ENT doctor.


There are a number of measures that you should be familiar with in order to prevent the condition including refraining from diving or travelling by plane when having an infection involving the upper respiratory tract or even severe congestion due to allergies.

The individual can also use decongestants or antihistamines if the sinus issue is triggered by allergies beforehand. On the other hand, if used excessively, decongestants can lead to rebound congestion. It is vital to manage allergies and underlying sinus conditions before flying or diving and always ensure that the individual descends or ascends in a steady manner using Valsalva maneuvers to equalize the pressure.

Sinus squeeze while diving

If the individual experiences symptoms of sinus barotrauma while diving, it is vital that he/she should not panic. The initial instinct is to swim up to the surface, but remember that rapid ascent will put him/her at risk for serious conditions such as decompression sickness or even barotrauma on other parts of the body such as the lungs and ears.

An exception to this rule is if the individual is bleeding profusely. If on dry land, follow the basic first aid if needed to stop nose bleeding. The pain must subside shortly after returning to sea level and a doctor should be consulted.

If there is severe bleeding or intense pain that does not settle, bring the individual to the emergency department. It is vital to be familiar with the symptoms of different types of barotrauma to determine if other parts of the body are affected.

Sinus barotrauma can be managed effectively by an ENT doctor without resulting to long-term damage. Those who engage in diving must undergo proper training on prevention of all types of barotrauma as well as decompression sickness.

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