title: Otosclerosis and Fitness to Fly.
abstract: BACKGROUND
  When an aircrew member is referred for otosclerosis, his flight fitness may be questionable. The objective of this retrospective study was to describe a case series of otosclerosis in an aircrew population and to discuss the decisions about their flight waivers.
  
  
  METHODS
  There were 27 aircrew members who were referred to the ENT-Head and Neck Surgery Department of the National Pilot Expertise Center. Their medical files were retrospectively examined.
  
  
  RESULTS
  Out of 16 patients who had surgery, 2 did not obtain a flight fitness waiver afterwards. Among the 14 who received waivers, 12 had no restrictions on their flight fitness. Among the nonoperated patients, 1 of 11 did not obtain a waiver. Seven patients were declared medically fit to fly without a waiver and three obtained a waiver.
  
  
  CONCLUSIONS
  Fitness was based on auditory and balance statuses and the follow-up of these findings. A postoperative CT-scan and the operative report were used to determine the quality of stapes surgery. Professional speech audiometry in noise might be as interesting. The results made it possible to determine a patient's fitness to fly with a waiver, which is more or less associated with restrictions. In our series, only 3 aircrew members out of 27 did not obtain a flight fitness waiver. The few published studies on the resumption of flight for patients who underwent surgery and our experience in France with similar waivers in commercial and military aviation suggest that under certain conditions and after relevant vestibulocochlear assessment, stapes surgery may allow for a safe recovery of aviation activity.
authors.affiliation: French Military Health Service, Military Training Hospital Percy, Clamart, France.
authors.forename: Stanislas
authors.initials: S
authors.lastname: Ballivet de Régloix
authors.forename: Jérome
authors.initials: J
authors.lastname: Gauthier
authors.forename: Yoann
authors.initials: Y
authors.lastname: Pons
authors.forename: Olga
authors.initials: O
authors.lastname: Maurin
authors.forename: Louise
authors.initials: L
authors.lastname: Genestier
authors.forename: Michel
authors.initials: M
authors.lastname: Kossowski
mesh_terms: D000328:Adult; D000337:Aerospace Medicine; D001302:Audiometry, Speech; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010040:Otosclerosis / Q000503:physiopathology / Q000601:surgery*; D010809:Physical Fitness; D004856:Postural Balance; D012189:Retrospective Studies; D062707:Return to Work / Q000706:statistics & numerical data*; D013201:Stapes Surgery; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014938:Work Capacity Evaluation