Guide for Aviation Medical Examiners

Aerospace Medical Dispositions
Item 26. Nose

The following lists the most common conditions of aeromedical significance, and course of action that should be taken by the examiner as defined by the protocol and disposition in the table. Medical certificates must not be issued to an applicant with medical conditions that require deferral, or for any condition not listed that may result in sudden or subtle incapacitation without consulting the AMCD or the RFS. Medical documentation must be submitted for any condition in order to support an issuance of an airman medical certificate.

Allergies or Anaphylaxis
Disease/Condition Class Evaluation Data Disposition
Allergies or Anaphylaxis
(Allergic rhinitis; Seasonal Allergic Rhinitis; Hay fever)		 All See Allergies or Anaphylaxis Disposition Table (PDF) See Allergies or Anaphylaxis Disposition Table
Obstruction of sinus ostia, including polyps, that would be likely to result in complete obstruction All Submit all pertinent medical information and current status report Requires FAA Decision
Anosmia*
All Classes
Disease/Condition Evaluation Data Disposition
A. KNOWN etiology

Including COVID-19 infection

If due to trauma associated with traumatic brain injury, tumor removal, etc., review that section for additional information or required recovery periods.		 No evaluations or follow-up needed if the AME can determine the condition is benign and the pilot has no other condition(s) that would interfere with flight duties:

Discuss with the pilot:

  • This condition may cause an inability to receive early warning of fuel leaks, exhaust fumes, or a fire (prior to visible smoke).
  • Importance of using of a carbon monoxide (CO) detector (not a spot detector) in all aircraft flown that have an internal combustion engine.
  • CO is odorless and tasteless; however, it is frequently accompanied by exhaust fumes that can be detected by smell. Encourage the pilot to ask someone else to verify the absence of fuel fumes in the cabin prior to flight.

 

ISSUE
Annotate this information in Block 60. For any identified underling condition(s), see that section.
B. UNKNOWN (or uncertain) etiology

For any duration.

 Submit the following to the FAA for review:
  • The most recent detailed Clinical Progress Note (actual clinical record) from an otolaryngologist (ENT).
  • It should include a summary of the history of the condition or diagnosis, current medications, clinical exam findings, results of any testing performed, diagnosis, assessment, plan (prognosis), and follow-up.
  • It must specifically include etiology if found.

 

DEFER
Submit the information to the FAA for a possible Special Issuance.

Follow up Issuance will be per the pilot's authorization letter.
*Anosmia-partial or complete loss of smell.
ENT evaluation required as some cases may be due to nasal polyps or nasal growth (tumor) which could be aeromedically significant.
Last updated: Wednesday, August 28, 2024