Hals, Nase und Ohren in der Schwerelosigkeit: die kosmischen Herausforderungen der HNO-Heilkunde

Zusammenfassung

Die bemannte Raumfahrt stellt besondere Anforderungen an den menschlichen Körper, auch an die Organe im HNO-Bereich. Diese Organe spielen eine entscheidende Rolle bei der Aufrechterhaltung der Gesundheit und Sicherheit der Astronauten im Weltraum. In diesem Beitrag werden häufige HNO-Probleme in der Raumfahrt besprochen, darunter Ödeme der oberen Atemwege, Mittelohr- und Mastoidergüsse, Hörverlust und Schwindel mit Übelkeit. Wir erörtern die zugrunde liegenden Mechanismen, die zu diesen Beschwerden beitragen, ihre klinischen Erscheinungsformen und mögliche Behandlungsstrategien. Darüber hinaus untersuchen wir die möglichen Auswirkungen dieser Erkrankungen auf die Gesundheit der Astronauten und die Ergebnisse der Mission. Schließlich betonen wir die Bedeutung von Präventivmaßnahmen und zukünftiger Forschung in diesem Bereich, um die Gesundheit und Sicherheit der Astronauten auf zukünftigen Missionen zu optimieren.

Abstract

Manned spaceflight places special demands on the human body, including the organs in the ENT region. These organs play a critical role in maintaining the health and safety of astronauts in space. In this paper, we review common ENT problems of spaceflight, including upper airway edema, middle ear and mastoid effusions, hearing loss, and dizziness with nausea. We discuss the underlying mechanisms contributing to these complaints, their clinical manifestations, and potential treatment strategies. In addition, we examine the potential impact of these conditions on astronaut health and mission outcomes. Finally, we emphasize the importance of preventive measures and future research in this area to optimize astronaut health and safety on future missions.

Keywords

ENT problems of spaceflight - astronaut health - research

Publication History

Article published online:
22 December 2023

• Literatur

• 1 Parazynski SE, Hargens AR, Tucker B. et al. Transcapillary fluid shifts in tissues of the head and neck during and after simulated microgravity. J Appl Physiol (1985) 1991; 71: 2469-2475
• 2 Hodkinson PD, Anderton RA, Posselt BN. et al. An overview of space medicine. Br J Anaesth 2017; 119 (Suppl. 01) i143-i153
• 3 Baker ES, Barratt MR, Wear ML. Human Response to Space Flight. In: Barratt MR, Pool SL. Principles of Clinical Medicine for Space Flight. Springer; 2008: 27-57
• 4 Marshall-Goebel K, Laurie SS, Alferova IV. et al. Assessment of Jugular Venous Blood Flow Stasis and Thrombosis During Spaceflight. JAMA Netw Open 2019; 2: e1915011
• 5 Inglesby DC, Antonucci MU, Spampinato MV. et al. Spaceflight-Associated Changes in the Opacification of the Paranasal Sinuses and Mastoid Air Cells in Astronauts. JAMA Otolaryngol Head Neck Surg 2020; 146: 571-577
• 6 Blue RS, Bayuse TM, Daniels VR. et al. Supplying a pharmacy for NASA exploration spaceflight: challenges and current understanding. NPJ Microgravity 2019; 5: 14
• 7 Lecheler L, Paulke F, Sonnow L. et al. Gravity and Mastoid Effusion. Am J Med 2021; 134: e181-e183
• 8 Huyett P, Raz Y, Hirsch BE. et al. Radiographic Mastoid and Middle Ear Effusions in Intensive Care Unit Subjects. Respir Care 2017; 62: 350-356
• 9 Stenger MB, Macias BR. Sinus Space in Outer Space. JAMA Otolaryngol Head Neck Surg 2020; 146: 578
• 10 Iannella G, Lucertini M, Pasquariello B. et al. Eustachian tube evaluation in aviators. Eur Arch Otorhinolaryngol 2017; 274: 101-108
• 11 Schilder AGM, Chonmaitree T, Cripps AW. et al. Otitis media. Nat Rev Dis Primers 2016; 2: 16063
• 12 Weber R, Kühnel T, Graf J. et al. Aerosinusitis: part 1: Fundamentals, pathophysiology and prophylaxis. HNO 2014; 62: 57-66
• 13 Weber R, Kühnel T, Graf J. et al. Aerosinusitis. Part 2: Diagnosis, therapy and recommencement of flight duties. HNO 2014; 62: 297-306
• 14 Jennings RT. Managing space motion sickness. J Vestib Res 1998; 8: 67-70
• 15 Thornton WE, Bonato F. Space motion sickness and motion sickness: symptoms and etiology. Aviat Space Environ Med 2013; 84: 716-721
• 16 Thornton W, Bonato F. The Human Body and Weightlessness. In: . Springer; 2017: 31-55
• 17 Diamond SG, Markham CH. Prediction of space motion sickness susceptibility by disconjugate eye torsion in parabolic flight. Aviat Space Environ Med 1991; 62: 201-205
• 18 Peterka RJ. Torsional vestibulo-ocular reflex measurements for identifying otolith asymmetries possibly related to space motion sickness susceptibility. Acta Astronaut 1994; 33: 1-8
• 19 Hallgren E, Migeotte PF, Kornilova L. et al. Dysfunctional vestibular system causes a blood pressure drop in astronauts returning from space. Sci Rep 2015; 5: 17627
• 20 Deshpande N, Laurie SS, Lee SMC. et al. Vestibular and Cardiovascular Responses After Long-Duration Spaceflight. Aerosp Med Hum Perform 2020; 91: 621-627
• 21 Buckey Jr JC, Musiek FE, Kline-Schoder R. et al. Hearing loss in space. Aviat Space Environ Med 2001; 72: 1121-1124
• 22 Roller CA, Clark JB. Short-duration space flight and hearing loss. Otolaryngol Head Neck Surg 2003; 129: 98-106
• 23 Clark JB, Allen CS. Acoustics Issues. In: Barratt MR, Pool SL. Principles of Clinical Medicine for Space Flight. Springer; 2008: 521-533
• 24 Abel SM, Crabtree B, Baranski JV. et al. Hearing and performance during a 70-h exposure to noise simulating the space station environment. Aviat Space Environ Med 2004; 75: 764-770
• 25 Kadem M. The etiology of spaceflight-associated hearing loss. UWOMJ 2018; 87: 31-33
• 26 Reschke MF, Cohen HS, Cerisano JM. et al. Effects of sex and gender on adaptation to space: neurosensory systems. J Womens Health (Larchmt) 2014; 23: 959-962