Sinus Block


  • Cavities in the bone of the skull and are lined with moist mucous membranes
  • The sinuses most frequently affected by pressure changes are the frontal sinuses
    • Frontal sinuses: located above and behind each eye
    • Maxillary sinuses: located in the bones of the cheeks behind the eyes


  • Air pressure in the sinuses equalize through small openings in the nasal passages during altitude changes
  • Either an upper respiratory infection, such as a cold or sinusitis, or a nasal allergic condition can produce enough congestion around an opening to slow equalization, and as the difference in pressure between the sinus and cabin mounts, eventually plug the opening
    • This "sinus block" occurs most frequently during descent
  • The Valsalva maneuver will usually alleviate the problem
  • Infections or allergies can produce enough congestion to slow equalization
  • Can occur in the frontal sinuses, located above each eyebrow, or in the maxillary sinuses located in each upper cheek
    • Produces excruciating pain over the sinus area
    • Maxillary sinus block can make upper teeth ache
    • Bloody mucus may discharge from the nasal passages
  • Decongestants can cause pilot impairment
  • Occur most often in the descent when the pressure difference across the duct is increased without relief

Sinus Block Prevention:

  • A sinus block is prevented by not flying with an upper respiratory infection or nasal allergic condition
  • Adequate protection is usually not provided by decongestant sprays or drops to reduce congestion around the sinus openings
  • Oral decongestants have side effects that can impair pilot performance


  • If a sinus block does not clear shortly after landing, a physician should be consulted
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