[The repercussions of variations in ambient air pressure on pulmonary airway dystrophy. Applications to scuba diving with mask, commercial air travel and stays in high-altitude settings]

Introduction: Pulmonary airway dystrophy (PAD) is a rare disease that may be either innate or acquired. Very few publications have been dedicated to the repercussions of the air pressure variations that may be encountered during an airplane journey in a pressurized cabin, an aerial tramway ascent or a stay in a high-altitude setting. Variations may also occur during deep-sea diving with modification of absolute air pressure.

State of knowledge: The published observations show that all PAD cases have been associated with accidents during exposure or with variations in ambient air pressure. The different published reports should be considered with maximum caution and circumspection. It is of the utmost importance to painstakingly study each case in view of proposing a line of conduct in accordance with the etiology and severity of the disease. It also matters to take into full account the activity under consideration (climbing into altitude or deep-sea diving); the risks incurred are by no means identical.

Perspectives: It would be of interest to hold a register of barotrauma cases or other accidents resulting from air pressure variations affecting persons with cystic lung disease or with pulmonary bullae in cases of PAD.

Conclusion: While expert opinions and recommendations differ from one another, and notwithstanding the assistance provided by thoracic tomodensitometry, a premium should be placed on caution. In contentious cases, it makes sense to obtain the informed opinion of a pneumologist or certified hyperbaric physician familiar with PAD and its possible complications.