Reverse sinus barotrauma with periorbital emphysema as an occupational hazard — a case report

Sinus barotrauma is the second most common diving injury among divers. It results from an imbalance between the pressure within the sinuses and the ambient pressure. It may occur not only as "barotrauma of descent" but also as "barotrauma of ascent/reverse barotrauma," which is less common. Here, we describe a professional diver who had worked at a fish farm for nearly 3 years, diving with SCUBA equipment, and developed reverse sinus barotrauma with periorbital emphysema. This diving injury is preventable. To help prevent it, divers must have adequate education and knowledge of diving physics, physiology, and injuries. They should also be aware of their health status and whether they are fit to dive on a given day. If in doubt, they should cancel the dive. If they are unable to equalize the pressure difference and/or experience sinus pain, they should stop descending, abort the dive, and seek medical evaluation and treatment.