Considerations

Nasal congestion and obstruction occur commonly during an upper respiratory tract infection. During this time flying should not take place unless the condition is very mild and not distracting, free of systemic symptoms, free of any Eustachian tube or nasal dysfunction and no medication is needed or taken.

Chronic congestion or obstruction is not uncommon. It is sometimes ignored by the individual who may not realise that their nasal function could be better. Common causes are chronic rhinitis or sinusitis, septal deformity, inferior turbinates hypertrophy, nasal polyps or a combination thereof. A malignancy can also cause nasal obstruction.

Chronic nasal congestion or obstruction leads to Eustachian tube dysfunction and sinus ventilation problems. This may result in barotrauma, incapacitating pain and possibly vertigo. Another possible consequence of nasal obstruction is obstructed sleep apnoea.

Freedom of nasal passages can be ascertained by examination, using a nasal speculum or an otoscope fitted with a large ear piece. A useful functional test is to ask the applicant to obstruct one nostril and breathe through the other. This should be possible without effort.

Information to be provided

  • An applicant with nasal congestion or obstruction should provide an ENT specialist report, unless the obstruction is clearly of a temporary nature i.e. due to a common cold, in which case resolution should be ascertained before completing the assessment.

Disposition

An applicant with nasal obstruction should be considered as having a condition that is of aeromedical significance unless:

  • The condition has been successfully treated; or
  • The condition is very mild only, with adequate nasal respiratory function and adequate ventilation of the sinuses and the middle ears, and is not progressive.