Maxillary sinus barotrauma with infraorbital nerve paraesthesia after breath-hold diving

Barosinusitis, or sinus barotrauma, is a sinonasal injury and/or inflammation that results when the aerated spaces of the nose and sinuses are exposed to an uncompensated change in ambient pressure. We describe a 19-year-old male diver who presented to our clinic on the fourth day following a breath-hold diving session. During descent on a constant weight monofin dive at the South Cyprus World Championship he began to experience symptoms due to the inability to equalise the pressure, particularly in the Eustachian tubes and middle ear cavities. He felt pain and pressure in the upper left half of his face, left upper molars, and under his left eye at 60 metres, and he continued diving down to 74 metres. At presentation to our clinic, he still had ecchymosis under his right eye and pain in his upper right teeth, half of his face, and ear. He also described tingling in the lower left half of his nose and the left half of his upper lip. He received decongestants, B vitamins, and underwent endoscopic sinus drainage which alleviated his symptoms alleviated over time. The diver reported complete resolution of tingling, numbness, and pain after three months. It should not be forgotten that if appropriate treatment is delayed, permanent changes may occur as a result of long-term compression of the nerve, and therefore patients should be monitored closely.