Frontal Sinusitis

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Frontal Sinusitis

By: Kyle Hopkins

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Background

Frontal sinusitis is a build-up of mucus in the frontal sinuses largely due to excessive mucus production or inflammation of the frontal sinuses, which then prevents the mucus from properly draining through the nasal passages. Although the body has mechanisms to prevent bacterial infection of the sinuses, bacteria can still infiltrate the sinuses. This is especially true when a bacterial infection follows a viral infection, such as the common cold. The presence of abnormal blockages, including nasal polyps, deviated nasal septum, and other cellular tissues such as frontal infundibular cells, can also restrict drainage of the mucus from the frontal sinuses.

Diagnosis

Patients with frontal sinusitis often display symptoms of nasal discharge, pressure in the frontal sinuses directly behind their eyes and eyebrows, a decreased ability to smell, a cough that worsens at nighttime, a sore throat, a worsening cold, and fever. It is important for physicians to distinguish between a viral cold and sinusitis by taking a full patient history. Ear, nose, and throat specialists are trained to check the nasal cavities for signs of unwanted blockages and inflammation and can sample the mucus for infection. Imaging is important in diagnosing frontal sinusitis, as well, and this is done through computer tomography (CT) and magnetic resonance imaging (MRI) scans. These scans will allow the physician to see any build-up of material that might be causing the limited drainage of the sinuses. Furthermore, nasal endoscopy is a critical aspect of diagnosis as it enables the physician to see the blockages.

 

Treatment

Frontal sinusitis treatment is dependent on the cause. Many infections can be cleared by themselves, but a medical treatment course can speed this process. Viral infections can be treated by a nasal spray or nasal decongestant that relieves the pressure in the sinuses by enhancing proper drainage of the sinuses. Bacterial infections are treated with a course of antibiotics, such as vancomycin or methylprednisolone, for approximately ten days. For major obstructions in the frontal sinuses that last for several weeks, surgery may be required.

 

Frontal Sinus Surgery

Acute frontal sinusitis is that which lasts for fewer than 12 weeks. Anything longer than 12 weeks is considered chronic frontal sinusitis. Chronic frontal sinusitis can be treated with surgery if antibiotics are unsuccessful in treating the sinuses, especially in the case of a deviated septum or nasal polyps. Primary endoscopic frontal sinusotomy centers on the removal of frontal recess cells that obstruct the sinuses. With minimal manipulation of the frontal sinus ostium, physicians are able to remove these cells to allow for proper mucus preservation. Long-term results from primary endoscopic frontal sinusotomy are excellent and relieve most sinus symptoms.

 

Expected Recovery

Most sinus infections are cleared within a week to two weeks, especially with the aid of nasal sprays and antibiotics. Patients who undergo frontal sinus surgery also have high prospects of recovering quickly. It is important to prevent long-term sinus complications by maintaining regular sinus check-ups in the weeks following treatment for the first six weeks and then every few months after that.