Safety of commercial airflight in patients with craniofacial diseases

The potential risk of pressure changes during commercial air travel causing the expansion of trapped intracranial air in post-operative patients is known. Current studies reveal that it is safe for patients with space-occupying brain lesions to fly various distances. Nevertheless, in patients with pre-flight symptoms thought to be due to mass effect or cerebral oedema, the administration of dexamethasone and anticonvulsants may help minimize the risk of further brain swelling and possible seizures during air flight. Besides other oral manifestations of barometric pressure changes, such as barodontalgia, clinicians should be familiar with this entity, take preventive measures, and periodically examine patients who fly planes. Clinicians should also search for occult pathologies such as leaking restorations or secondary caries lesions. Nevertheless, pneumocephalus is not a contraindication to early post-operative flying. More significant, prospective, multi-institutional studies will be necessary to validate these recent results.