Complications of Frontal Sinusitis

Abstract

Background: Despite the modern antibiotherapies applied in the practice of otorhinolaryngology, complications of frontal sinusitis are still considered a serious life threatening disease and still causing serious neurological sequelae. Aim: The purpose of this study is to evaluate epidemiology, clinical features and management of the frontal sinusitis’s complications. Study Design: Retrospective study. Methods: 45 patients with osseous, orbital or intracranial complications of frontal sinusitis admitted to our department from 2002 to 2016 were evaluated. The diagnoses were determined based on anamnesis, anterior rhinoscopy, and CT scans with coronal and axial projections. Results: In our study, the average age was 25, 7 (range: 11-75), most patients were male (33/45). The symptoms were: frontal headache in 89%, facial pain in 60% and palpebral edema in 56% and forehead swelling in 36%. Fever was found in 33%. Anterior rhinoscopy showed the presence of purulent discharge in the middle meatus in 18 patients, severe septal deviation in 8 patients and hypertrophic turbinate in 5 patients. 16 patients had osteomyelitis and subperiosteal abscess of the frontal bone, 12 had palpebral inflammatory edema, 9 had orbital cellulitis, 4 had periorbital cellulitis, 2 had epidural empyema, 1 has subdural empyema and 1 has frontal cerebral abscess. 23 patients were managed surgically. Most patients (91%) recovered to premorbid state without neurological sequelae. Conclusion: Complications of frontal sinusitis are rare, but can be dangerous and responsible of severe neurological and orbital sequelae. The early diagnosis and the multidisciplinary management is fundamental in terms of control of the disease.