The document discusses Eustachian tube dysfunctions in aviators. It covers the anatomy and functions of the Eustachian tube, causes of dysfunction like infections or trauma, and clinical conditions seen in aviators like barotrauma. Evaluation methods and management involve relieving symptoms, equalizing pressure through maneuvers, and treating any infections or predisposing factors. The success of treatment depends on early reporting, the extent of damage, and addressing underlying causes.

1. EUSTACHIAN TUBEEUSTACHIAN TUBE
DYSFUNCTIONS INDYSFUNCTIONS IN
AVIATORSAVIATORS

2. EUSTACHIANEUSTACHIAN TUBETUBE
DYSFUNCTIONS IN AVIATORSDYSFUNCTIONS IN AVIATORS
ANATOMY & FUNCTIONS OF ETANATOMY & FUNCTIONS OF ET
EVALUATION OF FUNCTIONSEVALUATION OF FUNCTIONS
CAUSES OF DYSFUNCTIONCAUSES OF DYSFUNCTION
CLINICAL CONDITIONS IN AVIATORSCLINICAL CONDITIONS IN AVIATORS
MANAGEMENTMANAGEMENT
PREVENTIONPREVENTION

3. EUSTACHIAN TUBEEUSTACHIAN TUBE
•31-38 mm. Fm LOWER PART OF
ANT WALL OF M E CAVITY &
PASSES DOWNWARDS 40°,
FORWARDS & MEDIALLY
• MEDIAL END IS HOOK-SHAPED
OPENING IN LATERAL WALL OF
NASOPX, BEHIND & ON LEVEL
WITH POST END OF INF TURB
•TWO PARTS – BONY MEDIAL 1/3
LINED BY LOW COLUMNAR &
LATERAL 2/3 FIBROCART LINED
BY CILIATED PSEUDOSTRAT
COLUMNAR , MUCOUS GLANDS.
• LUMEN IS NARROWEST AT
ISTHMUS

4. MUSCLES OF E. T.
1. INSERTED IN ET WALL1. INSERTED IN ET WALL
TENSOR PALATITENSOR PALATI
LEVATOR PALATILEVATOR PALATI
SALPINGOPHARYNGEUSSALPINGOPHARYNGEUS
2. INFLUENCE TUBAL OPENING2. INFLUENCE TUBAL OPENING
BY ANAT ASSOCIATIONBY ANAT ASSOCIATION
SUP PHARYNG COSTRICTORSUP PHARYNG COSTRICTOR
PALATOPHARYNGEUSPALATOPHARYNGEUS

5. FUNCTIONS OF ETFUNCTIONS OF ET
•VENTILATION OF MIDDLE EAR, &VENTILATION OF MIDDLE EAR, &
EQUALIZATION OF INTRATYMPANICEQUALIZATION OF INTRATYMPANIC
WITH AMBIENT AIR PRESSUREWITH AMBIENT AIR PRESSURE
•CLEARANCE OF SECRETIONS FROMCLEARANCE OF SECRETIONS FROM
MIDDLE EARMIDDLE EAR
•PROTECTION AGAINST REFLUX OFPROTECTION AGAINST REFLUX OF
NASOPHARYNGEAL SECRETIONSNASOPHARYNGEAL SECRETIONS

6. EVALUATION OF FUNCTIONSEVALUATION OF FUNCTIONS
1 CLINICAL EXAM – OTOSCOPY, VALSALVA1 CLINICAL EXAM – OTOSCOPY, VALSALVA
2 RIGID ENDOSCOPY OF2 RIGID ENDOSCOPY OF NASOPxNASOPx
3 TYMPANOMETRY-3 TYMPANOMETRY-
M.E.PRESS, COMPLIANCEM.E.PRESS, COMPLIANCE
INTACT TM, PERF , SEC O M ,INTACT TM, PERF , SEC O M ,
PATULOUS ETPATULOUS ET
4 RADIOLOGY- X-RAY, CT SCAN, MRI4 RADIOLOGY- X-RAY, CT SCAN, MRI

7. EVALUATION OF FUNCTIONSEVALUATION OF FUNCTIONS
 55 POLITERIZATIONPOLITERIZATION
6 E T CANN-MAY BE HARMFUL6 E T CANN-MAY BE HARMFUL
7 FIBEROP EXAM OF ET THROUGH7 FIBEROP EXAM OF ET THROUGH
NASOPx / TYMPANIC CAVITYNASOPx / TYMPANIC CAVITY
8 VENTILATION SCINTIGRAPHY8 VENTILATION SCINTIGRAPHY
9 DECOMPRESSION CHAMBER-
AIRCREW

8. CAUSES OF DYSFUNCTIONCAUSES OF DYSFUNCTION
•CONGENITAL - STENOSIS OF ET,CONGENITAL - STENOSIS OF ET,
CLEFT PALATE, DENTALCLEFT PALATE, DENTAL
MALOCCLUSIONMALOCCLUSION
•TRAUMA -SKULL BASETRAUMA -SKULL BASE
•INFECTIVE – VIRAL/BACTERIAL URTI,INFECTIVE – VIRAL/BACTERIAL URTI,
SINUSITIS CAUSING SALPINGITISSINUSITIS CAUSING SALPINGITIS
•HYPERTROPHIC ADENOIDSHYPERTROPHIC ADENOIDS

9. CAUSES OF DYSFUNCTIONCAUSES OF DYSFUNCTION
•ALLERGIC - MUCOSAL EDEMA,ALLERGIC - MUCOSAL EDEMA,
INCREASED VISCOSITY OF MUCUSINCREASED VISCOSITY OF MUCUS
•NEOPLASTIC- NPC, LYMPHOMANEOPLASTIC- NPC, LYMPHOMA
•IATROGENIC –ADENOIDECTOMYIATROGENIC –ADENOIDECTOMY

10. CLINICAL CONDITIONSCLINICAL CONDITIONS
IN AVIATORSIN AVIATORS
•ACUTE OTITIC BAROTRAUMA (BT)ACUTE OTITIC BAROTRAUMA (BT)
•DELAYED OTITIC BAROTRAUMADELAYED OTITIC BAROTRAUMA
•RECURRENT OTITIC BAROTRAUMARECURRENT OTITIC BAROTRAUMA
•INNER EAR BAROTRAUMAINNER EAR BAROTRAUMA
•ALTERNOBARIC VERTIGOALTERNOBARIC VERTIGO
•ALTERNOBARIC FACIAL PARESISALTERNOBARIC FACIAL PARESIS

11. INCIDENCEINCIDENCE
EXACT INCIDENCE - NOT KNOWNEXACT INCIDENCE - NOT KNOWN
ALTITUDE CHAMBER TESTS –ALTITUDE CHAMBER TESTS –
COMMONEST ADVERSE REACTIONCOMMONEST ADVERSE REACTION
BAROTITIS 3.2%, ABD GAS PAIN 0.7%,BAROTITIS 3.2%, ABD GAS PAIN 0.7%,
AEROSINUSITIS 0.25 %AEROSINUSITIS 0.25 %
COMMERCIAL AIRLINERS –COMMERCIAL AIRLINERS –
PASSENGERSPASSENGERS
7-10% ADULTS & 15-22% CHILDREN7-10% ADULTS & 15-22% CHILDREN
U S A F – 8 / 1000 / YRU S A F – 8 / 1000 / YR

12. INCIDENCEINCIDENCE
IAFIAF
1 YR AFCME1 YR AFCME
TOTAL LMC AIRCREWTOTAL LMC AIRCREW
= 400= 400
E T DYSFUNCTIONE T DYSFUNCTION
= 06= 06
FIGHTER = 05FIGHTER = 05
TPT = 01TPT = 01FIGHTERS- 5
TPORT-1
TOTAL NO: OF LMC CASES 400
REST 396
ETD
04

13. ACUTE OTITICACUTE OTITIC
BAROTAUMABAROTAUMA
COMMONEST CLINICAL CONDITIONCOMMONEST CLINICAL CONDITION
CAUSED BY ET DYSFUNCTIOSCAUSED BY ET DYSFUNCTIOS
•AERO-OTITIS MEDIAAERO-OTITIS MEDIA
•BAROTITISBAROTITIS
•AVIATION PRESSURE DEAFNESSAVIATION PRESSURE DEAFNESS
•DYSBARISMDYSBARISM
•MIDDLE EAR BAROTRAUMAMIDDLE EAR BAROTRAUMA

14. ME & ET DURING ASCENTME & ET DURING ASCENT
REDUCING AMBIENTREDUCING AMBIENT
PRESSURE CAUSESPRESSURE CAUSES
RELATIVE POSITIVERELATIVE POSITIVE
PRESSURE IN MEPRESSURE IN ME
AIR IN M E EXPANDSAIR IN M E EXPANDS
T M BULGES OUTT M BULGES OUT
ET OPENS PASSIVELYET OPENS PASSIVELY
AT 500-1000 FT & AIRAT 500-1000 FT & AIR
ESCAPES FROM THEESCAPES FROM THE
MEDIAL END TOMEDIAL END TO
EQUALISE THE PRESSEQUALISE THE PRESS

15. ME & ET DURING DESCENTME & ET DURING DESCENT
ME PRESSURE LESS. TMME PRESSURE LESS. TM
FORCED INWARDSFORCED INWARDS
ACTS OF SWALLOW, YAWNACTS OF SWALLOW, YAWN
OR VALSALVA , FRENZEL’SOR VALSALVA , FRENZEL’S
MANOEUVRES E T OPENSMANOEUVRES E T OPENS
FOR AIR TO ENTER &FOR AIR TO ENTER &
EQUALISE PRESSUREEQUALISE PRESSURE
UNLESS PRESSURE ISUNLESS PRESSURE IS
EQUALISED, BAROTRAUMAEQUALISED, BAROTRAUMA
MAY OCCUR IF DESCENT ISMAY OCCUR IF DESCENT IS
CONTINUEDCONTINUED
IF PRESS DIFF 90 mmHg,IF PRESS DIFF 90 mmHg,
LOCKING OF ET OCCURSLOCKING OF ET OCCURS

16. •ET INFLAMMATION (MOST COMMON
CAUSES: URTI & ALLERGIC
RHINITIS)
•MUCO–CILIARY DISORDERS e.g.
KARTAGENER’S SYNDROME
•PALATAL MUSCLE DISORDERS e.g.
CLEFT PALATE
•EXTRINSIC OBSTN OF ET OPENING e.g.
ADENOID HYPERTROPHY,
MASS IN NASOPX
PREDISPOSING FACTORSPREDISPOSING FACTORS

17. PATHOPHYSIOLOGYPATHOPHYSIOLOGY
DUE TO NEGATIVE PRESSURE IN ME: –DUE TO NEGATIVE PRESSURE IN ME: –
•VASCULAR CHANGES – ENGORGEMENTVASCULAR CHANGES – ENGORGEMENT
OF BLOOD VESSELS IN T M CAUSES CONGOF BLOOD VESSELS IN T M CAUSES CONG
& INTERSTITIAL HEMORRHAGE IN T M& INTERSTITIAL HEMORRHAGE IN T M
•ENGORGEMENT OF BLOOD VESSELS INENGORGEMENT OF BLOOD VESSELS IN
MUCOSA CAUSESMUCOSA CAUSES M E TRANSUDATES –M E TRANSUDATES –
SEROUS, SEROSANGUINOUS ORSEROUS, SEROSANGUINOUS OR
HAEMORRHAGICHAEMORRHAGIC
•RUPTURE OF BVs MAY LEAD TO FRANKRUPTURE OF BVs MAY LEAD TO FRANK
HAEMOTYMPANUMHAEMOTYMPANUM

18. PATHOPHYSIOLOGYPATHOPHYSIOLOGY
• INITIALLY TM RETRACTED WITHINITIALLY TM RETRACTED WITH
VASCULAR ENGORGEMENT IN ATTICVASCULAR ENGORGEMENT IN ATTIC
AND ALONG HANDLE OF MALLEUS,AND ALONG HANDLE OF MALLEUS,
& LATER IN WHOLE OF TM& LATER IN WHOLE OF TM
• STILL LATER BULGE OF TM & RUPTURESTILL LATER BULGE OF TM & RUPTURE
AT HIGHER PRESSURE DIFFERENTIALAT HIGHER PRESSURE DIFFERENTIAL

19. CLINICAL FEATURESCLINICAL FEATURES
•SYMPTOMS:SYMPTOMS:
•ONE / BOTH EARSONE / BOTH EARS
BLOCKAGE / FULLNESSBLOCKAGE / FULLNESS
PAIN : DULL ACHE, SEVEREPAIN : DULL ACHE, SEVERE
DISCHARGE FROM EAR (BLOODDISCHARGE FROM EAR (BLOOD
STAINED)STAINED)
DEAFNESS, TINNITUS & VERTIGODEAFNESS, TINNITUS & VERTIGO

20. 60 mm Hg P.D.– PAIN SEVERE &60 mm Hg P.D.– PAIN SEVERE &
RESEMBLES THAT OF Ac OTITISRESEMBLES THAT OF Ac OTITIS
MEDIAMEDIA
60-80 mm Hg P.D. – PAIN INTENSE,60-80 mm Hg P.D. – PAIN INTENSE,
RADIATES TO TEMPLE & CHEEKRADIATES TO TEMPLE & CHEEK
80-100 mm Hg P.D. – PAIN AGONIZING,80-100 mm Hg P.D. – PAIN AGONIZING,
LOCALIZED DEEP IN PAROTID REGIONLOCALIZED DEEP IN PAROTID REGION
100-200 mm Hg P.D. – TM RUPTURES &100-200 mm Hg P.D. – TM RUPTURES &
SYMPTOMS DEPENDING ONSYMPTOMS DEPENDING ON
PRESS DIFFERENTIALPRESS DIFFERENTIAL

21. EVIDENCE OF URTIEVIDENCE OF URTI
OTOSCOPIC EXAM : TM CONGESTION-OTOSCOPIC EXAM : TM CONGESTION-
ATTIC, ALONG HANDLE OF MALLEUS,ATTIC, ALONG HANDLE OF MALLEUS,
ALONG MALLEOLAR FOLDS, PERIPHERY.ALONG MALLEOLAR FOLDS, PERIPHERY.
DISTORTION OF CONE OF LIGHTDISTORTION OF CONE OF LIGHT
TM RETRACTED OR BULGEDTM RETRACTED OR BULGED
FLUID IN MEFLUID IN ME
RUPTURE OF TM- ANTEROINF QUAD /RUPTURE OF TM- ANTEROINF QUAD /
ATROPHIC AREAATROPHIC AREA
SIGNS:SIGNS:
CLINICALCLINICAL
FEATURESFEATURES

22. TM INVAGINATEDTM INVAGINATED
WITH MINIMAL CONGESTIONWITH MINIMAL CONGESTION

23. SCATTERED INTERSTITIALSCATTERED INTERSTITIAL
HAEMORRHAGES IN TMHAEMORRHAGES IN TM

24. UNRESOLVED OTITIC BAROTRAUMA
WITH AMBER COLOURED EFFUSION
IN ME.

25. RUPTURE IN ANTEROINFERIOR
QUADRANT OF TM

26. INVESTIGATIONSINVESTIGATIONS
•TYMPANOMETRY-TYMPANOMETRY-
LOW COMPLIANCE,LOW COMPLIANCE,
DECREASED M E PRESSUREDECREASED M E PRESSURE
IF NO TRANSUDATE- TYPE B CURVEIF NO TRANSUDATE- TYPE B CURVE
TRANSUDATE -TYPE C CURVETRANSUDATE -TYPE C CURVE
PERFORATION – TYPEPERFORATION – TYPE C CURVEC CURVE
•PTA- CONDUCTIVE H LPTA- CONDUCTIVE H L
IN LOW FREQUENCIESIN LOW FREQUENCIES
•X-RAYS- PNS, MASTOIDX-RAYS- PNS, MASTOID

27. MANAGEMENT IN FLIGHT
•WITH THE FIRST FEELING OF EARWITH THE FIRST FEELING OF EAR
FULLNESS, AVIATOR SHOULDFULLNESS, AVIATOR SHOULD
PERFORM VALSALVA / FRENZEL’SPERFORM VALSALVA / FRENZEL’S
•NASAL DECONGESTANTSNASAL DECONGESTANTS
•RETURN TO HIGHER ALTITUDE,RETURN TO HIGHER ALTITUDE,
PERFORM VALSALVA, & DESCENDPERFORM VALSALVA, & DESCEND
GRADUALLYGRADUALLY

28. MANAGEMENT ON GROUNDMANAGEMENT ON GROUND
TO RELIEVE PAIN – ANALGESICSTO RELIEVE PAIN – ANALGESICS
TO EQUALIZE INTRATYMPANIC &TO EQUALIZE INTRATYMPANIC &
AMBIENT PRESSURES – LOCAL & SYSTAMBIENT PRESSURES – LOCAL & SYST
DECONGESTANTSDECONGESTANTS
---- DECOMP CHAMBER? He,O2 MIX??DECOMP CHAMBER? He,O2 MIX??
IF NO TRANSUDATE -VALSALVA,IF NO TRANSUDATE -VALSALVA,
POLITERISATIONPOLITERISATION
IF TRANSUDATE / PERF- ANTIBIOTICSIF TRANSUDATE / PERF- ANTIBIOTICS
LATER,MYRINGOTOMY /T’LASTYLATER,MYRINGOTOMY /T’LASTY
TO IDENTIFY & TREAT CAUSAL /TO IDENTIFY & TREAT CAUSAL /
PREDISPOSING FACTORSPREDISPOSING FACTORS

29. SUCCESS OF TREATMENTSUCCESS OF TREATMENT
DEPENDS UPONDEPENDS UPON
TIME OF REPORTING SICKTIME OF REPORTING SICK
DEGREE OF DAMAGE SUSTAINED TODEGREE OF DAMAGE SUSTAINED TO
TUBAL & ME MUCOSATUBAL & ME MUCOSA
NATURE OF PREDISPOSING CAUSESNATURE OF PREDISPOSING CAUSES

30. TREATMENT FOR 3 WEEKS AT SMCTREATMENT FOR 3 WEEKS AT SMC
 IF NO SIGNS OR SYMPTOMS,IF NO SIGNS OR SYMPTOMS,
 IF TM , HEARING NORMAL -IF TM , HEARING NORMAL -
REFLIGHTREFLIGHT
IF NOT RESPONDING, REFER TOIF NOT RESPONDING, REFER TO
ENT SPL FOR Rx. & PLACING INENT SPL FOR Rx. & PLACING IN
LMCLMC
REVIEW AT IAM/ AFCMEREVIEW AT IAM/ AFCME : -: -
 ENT EVALUATIONENT EVALUATION
 PTA & TYMPANOMETRYPTA & TYMPANOMETRY
 EAR CLEARANCE RUNEAR CLEARANCE RUN
DISPOSALDISPOSAL

31. DELAYED OTITIC BTDELAYED OTITIC BT
 SEEN AFTER LONG FLT / NIGHT FLYINGSEEN AFTER LONG FLT / NIGHT FLYING
BREATHING 100% OXYGENBREATHING 100% OXYGEN
 EAR-ACHE / PAIN & DULLNES /EAR-ACHE / PAIN & DULLNES /
DEAFNESS SEVERAL HRS AFTER THEDEAFNESS SEVERAL HRS AFTER THE
FLIGHTFLIGHT
 DUE TO RAPID ABSPN OF ODUE TO RAPID ABSPN OF O22 THRU’ M ETHRU’ M E
MUCOSA, & NON REPLACEMENTMUCOSA, & NON REPLACEMENT
BECAUSE OF LACK OF E T OPENINGBECAUSE OF LACK OF E T OPENING
LEADING TO NEGATIVE PRESS IN M ELEADING TO NEGATIVE PRESS IN M E
 IRRITN BY DRYIRRITN BY DRY OO22 CAUSES SALPINGITISCAUSES SALPINGITIS

32. DELAYED OTITIC BTDELAYED OTITIC BT
 SYMPTOMS NOT AS SEVERE AS ACUTESYMPTOMS NOT AS SEVERE AS ACUTE
OTITIC BTOTITIC BT
 O/E: RETRACTATION OF TMO/E: RETRACTATION OF TM
THERE MAY BE FLUID IN M ETHERE MAY BE FLUID IN M E
 PREVENTION &PREVENTION & MANAGEMENT: -MANAGEMENT: -
– AVOID SLEEPING IMMEDIATELY AFTERAVOID SLEEPING IMMEDIATELY AFTER
THE SORTIETHE SORTIE
– ACTIVE FILLING OF MIDDLE EARS WITHACTIVE FILLING OF MIDDLE EARS WITH
AIR BY FREQUENT VALSALVA AFTERAIR BY FREQUENT VALSALVA AFTER
LANDINGLANDING
– NASAL, SYSTEMICNASAL, SYSTEMIC DECONGESTANTS,DECONGESTANTS,
FREQUENT VALSALVAFREQUENT VALSALVA

33. INNER EAR BAROTRAUMAINNER EAR BAROTRAUMA
•EXACT AETIOLOGY NOT KNOWNEXACT AETIOLOGY NOT KNOWN
• OVERVIGOROUS VALSALVA TOOVERVIGOROUS VALSALVA TO
EQUALISE M E PEQUALISE M E P
• IF E T PATENT : SUDDEN INCREASE OF MIF E T PATENT : SUDDEN INCREASE OF M
E P CAUSING IMPLOSIVE RUPTURE OF RWE P CAUSING IMPLOSIVE RUPTURE OF RW
MEMB & DAMAGE TO ANNULAR LIG OFMEMB & DAMAGE TO ANNULAR LIG OF
FT PLATE CAUSING PERILYMPH LEAKFT PLATE CAUSING PERILYMPH LEAK
• IF E T NOT PATENT: SUDDEN INCREASEIF E T NOT PATENT: SUDDEN INCREASE
IN CSF PRESS CAUSING EXPLOSIVEIN CSF PRESS CAUSING EXPLOSIVE
RUPTURE OF RW MEMB LEADING TORUPTURE OF RW MEMB LEADING TO
PERILYMPH FISTULAPERILYMPH FISTULA

34. INNER EAR BAROTRAUMAINNER EAR BAROTRAUMA
PRESENTS WITH FLUCTUATING S N H L,PRESENTS WITH FLUCTUATING S N H L,
TINNITUS & SEVERE PERSISTENT VERTIGOTINNITUS & SEVERE PERSISTENT VERTIGO
MANAGEMENT :MANAGEMENT :
OBSVN, BED REST, LAB SEDATIVESOBSVN, BED REST, LAB SEDATIVES
IF NO IMPROVEMENT IN 2 WKS :IF NO IMPROVEMENT IN 2 WKS :
TYMPANOTOMYTYMPANOTOMY
LONG TERM PROGNOSIS POORLONG TERM PROGNOSIS POOR

35. ALTERNOBARIC VERTIGOALTERNOBARIC VERTIGO
•“PRESSURE VERTIGO”PRESSURE VERTIGO”
•DUE TO PASSIVE EQUILIBRIUM IN M E PRESSUREDUE TO PASSIVE EQUILIBRIUM IN M E PRESSURE
DURING RAPID ASCENTDURING RAPID ASCENT
•FORCED VALSALVA CAUSING SUDDEN OVERPRESSUREFORCED VALSALVA CAUSING SUDDEN OVERPRESSURE
IN M E DURING DESCENTIN M E DURING DESCENT
•SUDDEN ONSET, TRANSIENT ROTATORY VERTIGOSUDDEN ONSET, TRANSIENT ROTATORY VERTIGO
ASSOCIATED WITH NYSTAGMUSASSOCIATED WITH NYSTAGMUS
•OCCURS WITH URTI (‘STICKY TUBES’)OCCURS WITH URTI (‘STICKY TUBES’)
•ASYMMETRIC TUBAL OPENING PRESSURESASYMMETRIC TUBAL OPENING PRESSURES
•MANAGEMENT – PREVENTIVEMANAGEMENT – PREVENTIVE
•I F ATTACKS RECURRENT - PERILYMPHATIC FISTULAI F ATTACKS RECURRENT - PERILYMPHATIC FISTULA
SHOULD BE RULED OUTSHOULD BE RULED OUT

36. INSTRUCTIONS FOR AVIATORINSTRUCTIONS FOR AVIATOR
DURING DESCENTDURING DESCENT
•ACTIVE OPENING OF EUSTACHIAN TUBE –ACTIVE OPENING OF EUSTACHIAN TUBE –
YAWNING, SWALLOWING,JAW MOVEMENTSYAWNING, SWALLOWING,JAW MOVEMENTS
•VALSALVA MANOEUVRE: LIPS CLOSED,VALSALVA MANOEUVRE: LIPS CLOSED,
PINCHED NOSTRILS, FORCED EXPIRATIONPINCHED NOSTRILS, FORCED EXPIRATION
•FRENZEL’S MANOEUVRE: LIPS & GLOTTISFRENZEL’S MANOEUVRE: LIPS & GLOTTIS
CLOSED,PINCHED NOSTRILS,CONTRACTION OFCLOSED,PINCHED NOSTRILS,CONTRACTION OF
MUSCLES OF MOUTH & PHARYNXMUSCLES OF MOUTH & PHARYNX
•DO NOT NEGLECT TO VENTILATE M E DUE TODO NOT NEGLECT TO VENTILATE M E DUE TO
OTHER TASKSOTHER TASKS

37. PREVENTIONPREVENTION
• SELECTIONSELECTION : EXCLUSION OF CANDIDATES: EXCLUSION OF CANDIDATES
WITH NASAL ALLERGY & CHR SINUSITIS;WITH NASAL ALLERGY & CHR SINUSITIS;
SCARRED OR THINNED OUT T M .SCARRED OR THINNED OUT T M .
•EAR COMPRESSION RUNEAR COMPRESSION RUN
•INDOCTRINATION OF AIRCREWINDOCTRINATION OF AIRCREW
•NO FLYINGNO FLYING WITH COLD, URTI /WITH COLD, URTI /
INCOMPLETELY RESOLVED BAROTRAUMA/INCOMPLETELY RESOLVED BAROTRAUMA/
IF AVIATOR IS IGNORANT OF METHODSIF AVIATOR IS IGNORANT OF METHODS
OF AUTO INFLATIONOF AUTO INFLATION

38. CONCLUSIONCONCLUSION
•AWARENESS AMONG AIRCREWAWARENESS AMONG AIRCREW
ABOUT THESE CLINICALABOUT THESE CLINICAL
CONDITIONS IS NECESSARY.CONDITIONS IS NECESSARY.
•PREVENTIVE MEASURES SHOULDPREVENTIVE MEASURES SHOULD
BE KNOWN AND PRACTISED.BE KNOWN AND PRACTISED.
•NO FLYING EVEN WITH THENO FLYING EVEN WITH THE
SLIGHTEST MEDICAL PROBLEMS –SLIGHTEST MEDICAL PROBLEMS –
URTIURTI.

39. THANK YOU