Objective: This study aimed to assess the potential role of pneumatisation of the mastoid and its communicating air cells in the development of middle-ear barotrauma in aircrew members.
Methods: Seventy-nine aircrew members (158 ears) underwent temporal computed tomography. All were assessed before flying by clinical examination and audiology evaluation, followed by post-flight examination to detect barotrauma.
Results: Aircrew members' ears were divided into 3 groups based on barotrauma and temporal bone pneumatisation: 33 ears with barotrauma and temporal bone pneumatisation of 71 cm3 or greater (group A); 12 ears with barotrauma and temporal bone pneumatisation of 11.2 cm3 or lower (group B); and 113 ears with no barotrauma (group C). Mean pneumatisation volumes were 91.05 cm3, 5.45 cm3 and 28.01 cm3 in groups A, B and C, respectively. A direct relationship was observed between volume of temporal bone pneumatisation of 71 cm3 or greater and barotrauma grade.
Conclusion: Pneumatisation volume of the mastoid and its communicating air cells that ranges from 11.3 cm3 to 70.4 cm3 serves as a reliable predictor of the avoidance of middle-ear barotrauma associated with flying in aircrew members who have normal resting middle-ear pressure and good Eustachian tube function.
Keywords: Air Travel; Barotrauma; Mastoid; Middle Ear; Temporal Bone.