It is an exciting time in human spaceflight, with the advent of commercial spaceflight and the new Artemis Program to return astronauts to the moon. Although it has been 50 years since the Apollo 11 moon landing and 20 years since humans began continuously residing on the International Space Station (ISS), researchers continue to make novel discoveries regarding the human body in space. In this issue of JAMA Otolaryngology–Head & Neck Surgery, Inglesby et al1 report on magnetic resonance imaging opacification of the paranasal sinus and mastoid air cells after Space Shuttle and ISS missions. As with many spaceflight-related findings, the magnitude of change is greater after longer-duration ISS missions (approximately 6 months) than Space Shuttle missions (approximately 2 weeks). No differences were found in the paranasal sinuses, but long-duration spaceflight was associated with an increased odds ratio of developing mastoid effusions by 9.28 compared with short-duration spaceflight. The authors hypothesize that this may be because of eustachian tube dysfunction or venous sinus pathology. While astronauts frequently report a subjective sensation of nasal and sinus congestion, there are only a handful of documented cases of sinusitis or otitis media in space,2 making venous congestion secondary to microgravity-induced headward fluid shifts the likely culprit.3
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Stenger MB, Macias BR. Sinus Space in Outer Space. JAMA Otolaryngol Head Neck Surg. Published online March 26, 2020. doi:10.1001/jamaoto.2020.0274
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