Nasal Polyposis and Fitness to Fly

When a pilot is referred for nasal polyposis, his/her flight fitness may be questionable. The objective of this retrospective study was to describe a case series of barotrauma in a pilot population exhibiting nasal polyposis and to discuss the decisions about their flight fitness.

There were 17 pilots with nasal polyposis who were referred to the Head and Neck Department of the National Pilot Expertise Center. The study was declarative on the occurrence of ear and sinus barotrauma during the last 5 yr. Nasofibroscopy was performed to determine the stage of the nasosinus polyposis.

Out of 17 pilots, 1 did not obtain flight fitness clearance. Among the 16 who received fitness clearance to fly, 2 had restrictions on their flight fitness. Out of 17 patients, 8 had sinus barotrauma and 13 had middle ear barotrauma. A total of 21 cases of sinus barotrauma were reported, 17 involving the frontal sinus and 4 involving the maxillary sinus. Also reported were 48 cases of middle ear barotrauma.

Flight fitness was based on the recurrence of barotrauma episodes, their severity, in-flight incapacitation due to hyperalgesic sinusitis or otitis, and the failure of medical and/or surgical treatments. In our series, nasal polyposis did not seem to be a risk factor for severe barotrauma. The results made it possible to determine a patient's fitness to fly and any restrictions. The published studies on the resumption of flight for patients who have nasal polyposis and our experience suggest that nasal polyposis may allow a safe pursuit of aviation activity. Crambert A, Marchi Y, Pons Y, Podeur P, Allali L, Ballivet de Régloix S. Nasal polyposis and fitness to fly. Aerosp Med Hum Perform. 2024; 95(11):841-844.