Nose, Sinus, Larynx - Medical Standards for Enlistment and Appointment

Nose, Sinuses, and Larynx - Military Medical Disqualifications

Nose, Sinus, Larynx
••• Military Medicine.

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The nose, sinuses, and larynx are intricately connected and even partially linked with the Eustachian tubes which lead into the ear. Many medical professionals specialize in the Ear, Nose, and Throat region of the body. However, for the purposes of this article the disqualifying medical conditions are listed below are focused on the nose, it’s sinus passages, and the larynx, or voice box of the throat region.

The causes for rejection for appointment, enlistment, and induction (without an approved waiver) are an authenticated history of:

Rhinitis / Sinusitis

Rhinitis – There are two types of rhinitis – allergic and non-allergic. Having a bout with allergies is very common, so do not fear that you cannot serve because you have rhinitis in your record. However, when attending Military Entrance Processing Stations (MEPS) or Department of Defense Medical Examination Review Board (DODMERB) a recruit or candidate has a current allergic or non-allergic rhinitis and it is not easily controlled by oral topical medication, it is disqualifying. The exact way the military regulation reads as follows:

(The International Classification of Disease (ICD) codes are listed in parentheses following each standard)

(1) Current allergic rhinitis (477.0), due to pollen (477.8) or due to other allergen or cause unspecified (477.9), if not controlled by oral medication or topical corticosteroid medication, is disqualifying. History of allergic rhinitis immunotherapy within the previous year is disqualifying.

(2) Current chronic non-allergic rhinitis (472.0), if not controlled by oral medication or topical corticosteroid medication, is disqualifying.

Sinusitis, also known as a sinus infection (rhinosinusitis) is a common condition in which the sinus cavities become inflamed and swollen for at least 12 weeks and medical treatment is not working. A sinus infection interferes with sinus drainage and causes mucus buildup within the nose and sinus cavities. Symptoms will be difficulty breathing in and out of your nose and face pain above, below, and between the eyes (sinus cavities locations). The exact way the military regulation reads as follows:

Current chronic sinusitis (473), or current acute sinusitis (461.9), is disqualifying. Such conditions exist when evidenced by chronic purulent nasal discharge, hyperplastic changes of the nasal tissue, symptoms requiring frequent medical attention, or x-ray findings.

Vocal Cord / Larynx Disqualifications

The Larynx is the hollow muscular organ forming an air passage to the lungs and holding the vocal cords in humans and other mammals; it is also known as the voice box.  It is quite the complex organ in the body as it is responsible for human language and vocalization which enabled us to advance as a species. The larynx is made up of six pieces of cartilage and 17 muscles that are also connected to nerves that enable speech and other vocal utterances. When the larynx is damaged or congenitally defective it can be difficult for someone to speak, speak loudly, or even protect the trachea and prevent food / liquid from entering the lungs.

 The disqualifying factors of the larynx are the following:

Current chronic conditions of larynx including vocal cord paralysis (478.3), chronic hoarseness, chronic laryngitis, larynx ulceration, polyps, granulation tissue, or other symptomatic disease of larynx, vocal cord dysfunction not elsewhere classified (478.7) are disqualifying.

Loss of Smell

Anosmia is the inability to perceive odor or the complete loss of the sense of smell. Anosmia may be temporary, but some forms that stem from an illness or accident, can be permanent. Current anosmia or parosmia (781.1) is disqualifying. Parasmia is similar to anosmia, but it often means the patient confuses the smell of something with something else. For instance, a rose may smell like sewer water to a person with parosmia. Both of these ailments are disqualifying within military medicine.

Bloody Nose and Polyps

If a candidate or recruit has reoccurring instances of bloody noses not brought on by immediate trauma, this is called a history of recurrent epistaxis (784.7). If you get a bloody nose more than once per week of bright red blood from the nose occurring over a 3-month period, is disqualifying. Also, if a candidate has a history of nasal polyps it can be disqualifying. The exact regulation on nasal polyps reads as follows: Current nasal polyps (471) or history of nasal polyps, unless greater than 12 months has elapsed since nasal polypectomy, is disqualifying.

Septum Issues

A hole in the septum of the nose if not treated and is current (478.1) is disqualifying. A perforated septum is not always symptomatic. However, a hole in the septum can cause nosebleeds, and breathing issues.

Chewing, Swallowing, Speech, Breathing Impact

Obviously, any issue that causes disruption or difficulty with chewing, swallowing, speech, or breathing with respect to the nose and throat will be challenging to pass military medicine upon entry.

Current or history of tracheostomy (V44.0) or tracheal fistula (530.84) is disqualifying.

Current or history of deformities, or conditions or anomalies (750.9) of the upper alimentary tract, of the mouth, tongue, palate throat, pharynx, larynx, and nose that interfere with chewing, swallowing, speech, or breathing are disqualifying.

Current chronic pharyngitis (462) and chronic nasopharyngitis (472.2), are disqualifying.

Derived from Department of Defense (DOD) Directive 6130.3, "Physical Standards for Appointment, Enlistment, and Induction," and DOD Instruction 6130.4, "Criteria and Procedure Requirements for Physical Standards for Appointment, Enlistment, or Induction in the Armed Forces."