Analysis On Disease Spectrum Of Otorhinolaryngology In Pilots And Study Of Barotrauma

More high performance fighters were equipped in air force. In order to adapt the new hygiene requirement under current military affairs, we analyzed the disease spectrum of otorhinolaryngology in fighter pilots, present the empirical study and the clinical research of barotrauma of middle ear(BME). The whole study consists three parts.Part 1: Disease spectrum of otorhinolaryngology in pilotsWe collected 230 ENT cases consist of first generation fighter pilots(F5), second generation fighter pilots(F6) and third generation fighter pilots(F7), who have been in Airforce General Hospital from December 1965 to August 2005. All cases were divided according to their diagnosis. Results : (l)The most common ten diagnosis are BME, vertigo, noise-induced deafness, sinus BME, flying illusion, airsickness, allergic rhinitis, vestibular function abnormal, chronic rhinitis, Meniere disease;(2) Compared with F5 and F6, the disease spectrum of otorhinolaryngology in F7 is different. Incidence of some diseases decreased while incidence of others went up. BME is still among the most common three diseases;(3)The most common reason for disqualification of fighter pilots was BME. Investigating the mechanism, we could grasp the feature and regularity of diseases, study main disease.Part 2: Empirical study of BME30 health guinea-pigs were blocked 7 days in left nasal cavity to establish BME model. Hyopbaric chamber operation was done before blockage, and after blockage and treatment. Eardrum examination and tympanogram were carried out each time before and after the hyopbaric chamber operation. Results: There is significant difference in left eardrum and tympanogram before and after blockage of guinea-pigs' left nasal cavity, as well as after blockage and after treatment.Significant difference also can be seen between left ear and right after the blockage. The inflammation of nasal cavity, nasal sinuses and pharynx nasalis caused by blockage of nasal cavity do have influence to eustachian tube function. And it induced the middle ear BME during hyopbaric chamber operation at last. After treatment the tubal function recovered. This study may have some guidance in diagnosis, classification, treatment and health appraisal of BME in pilots.Part 3: Clinical research of BME82 pilots cases of BME treated at Airforce General Hospital from September 1979 to April 2006 were studied, including 27 primary and 55 secondary BME cases. Results: Healing rate of secondary BME is higher than that of primary BME significantly. Permanent grounded rate of secondary BME is lower than that of primary BME significantly. Primary BME is caused by recessive eustachian tube disfunction. Expectant treatment can't get good effect. Eardrum ventilating tube is insulting method and not prone to be accepted by pilots. Secondary BME is caused by pathological changes around pharyngeal opening of eustachian tube. Effective treatment of correlated diseases could have a good result in secondary BME.According to this study, BME plays an important role in clinical aviation medicine. We should have a comprehensive recognition of secondary BME. Early diagnosis and effective treatment is needed to prevent non-reversible pathological changes of eustachian tube from occuring and to lower permanent grounded rate. For primary BME, continued study is necessary in order to learn more.