Otolaryngological and Neuro-Vestibular Considerations for Commercial Spaceflight

The rapidly expanding commercial spaceflight (CSF) market has fueled increasing interest in spaceflight experiences among individuals without professional astronaut qualifications. Such individuals may present with a range of medical conditions that add uncertainties to medical preparation and risk assessment for spaceflight. As the ear, nose, and throat (ENT) working group of the Aerospace Medical Association Ad Hoc Committee on Commercial Spaceflight, we conducted a scoping review to assess the available biomedical literature for ENT and neuro-vestibular conditions and physiology pertinent to spaceflight for nonprofessional space travelers.

The scoping review was conducted in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analyses. The initial database search produced 3232 articles. This set was reduced to 142 relevant publications through a rigorous two-reviewer filtering process using strict inclusion and exclusion criteria.

Motion sickness and spatial disorientation were the most common topics of the final set of articles. In contrast, there was limited material on other relevant ENT topics such as hearing loss, sino-nasal dysfunction, and conditions of the pharynx. It becomes clear from this scoping review that the path forward in providing guidance for optimal medical management of CSF passengers will involve the integration of modern biomedical research findings with the accumulated clinical expertise in the civil and military aeromedical communities. We recommend building an industry-wide CSF medical database to address care gaps and improve specialized aerospace medical knowledge. Panic H, Wexler D, Stephanian B, Correia JP, Sides M, Hoffman T. Otolaryngological and neuro-vestibular considerations for commercial spaceflight. Aerosp Med Hum Perform. 2025; 96(9):841-850.