5例空泡蝶鞍飞行人员航空医学鉴定

Medical evaluation of empty sella in aircrew:a clinical analysis of 5 cases

目的探讨飞行人员空泡蝶鞍(empty sella,ES)的临床诊治及航空医学鉴定原则。方法收集我院2009-2015年收治的5例诊断为ES的飞行人员的临床诊治和医学鉴定资料,复习国内外相关文献。结果 5例男性(平均年龄42岁)均经头颅MRI检查明确诊断为ES,3例因头痛就诊,2例为检查发现。2例出现视觉障碍。5例均未发现明显的内分泌异常。2例给予飞行合格结论,经5~6年的飞行观察病情无进展;1例停飞,2例暂时飞行不合格。结论有明显临床症状者建议飞行不合格;体检发现的无症状、无功能障碍者飞行合格;双座机飞行人员经手术或药物治疗症状消失、无并发症,无药物不良反应者个别评定。

Objective To illustrate the areomedical considerations and certification issues for aircrew with empty sella（ES）. Methods The medical assessment data of 5 pilots with primary empty sella admitted to our hospital from 2009 to 2015 were retrospectively analyzed and its related literatures were reviewed. Results Of the 5 cases with average age of 42 years, 3 pilots were admitted for headache, 2 for other reasons and they were diagnosed as ES by cranial MRI. All of them had no apparent endocrine abnormality. Two patients presented with visual disorder. Two were permitted to return to flight and the illness showed no progression during the following 5 to 6 years. One was given flying disqualification permanently, the other two were grounded temporarily. Conclusion We suggest that ES pilots with serious symptoms and signs should be disqualified for flying. Those discovered incidentally and have no functional disorders can return to flight. If flying personnel of dual-seat flight with ES recovered without complication or drug adverse reaction after operation or drug therapy, waiver will be considered individually.