What Is Frontal Sinusitis?

Frontal sinusitis can be divided into acute frontal sinusitis and chronic frontal sinusitis. Acute frontal sinusitis is acute suppurative sinusitis, an acute purulent infection of the sinus mucosa. Acute frontal sinusitis is not treated in time or improperly treated, causing severe damage to the mucosa, loss of normal function, and chronic inflammation.

Basic Information

English name: frontal sinusitis
Visiting department: ENT

Common causes: Sinusogenic infection, nasal infection, adjacent tissue infection, etc.
Common symptoms: Headache or local pain
Contagious: no

Causes of frontal sinusitis

Sinus infection

The sinus and sinus ostium are relatively small. Once the stenosis or obstruction occurs, the ventilation and drainage of the sinus cavity are both affected and easy to accumulate pus, or become chronic inflammation. In addition, the sinus and sinus walls of each sinus are adjacent to each other. Inflammation of one sinus can easily affect adjacent sinuses.

Nasal infection

(1) Acute rhinitis: It is a common cause of sinusitis. It may be due to the continuous mucosa of the two that the inflammation can invade the sinuses.

(2) Other diseases of the nasal cavity: Deviation of the nasal septum, hypertrophy of the turbinate, hypertrophy of the mucous membrane, tumors and foreign bodies in the nasal cavity, and nasal allergies can block the sinus opening, making the sinus ventilation and drainage blocked and inflamed.

(3) Contaminants enter the sinuses through the nasal cavity: such as swimming, diving, diving, improper methods, or forcefully blow your nose after swimming, so that sewage enters the sinuses and becomes inflamed. Most of these infections are caused by anaerobic bacteria, and clinical symptoms are usually severe.

(4) The stuffing in the nasal cavity is left for too long; local irritation and contamination, as well as obstructed ventilation and drainage of the sinus orifice, cause inflammation.

3. Adjacent tissue infections

4. Bloodborne infections

5. Traumatic infection

Traumatic injuries such as fractures, foreign body retention, and blood clot infections; barometric injuries are caused by sudden changes in barometric pressure and are more common in the frontal and maxillary sinuses.

6. Systemic factors

Such as reduced immune function, diabetes, malnutrition, vitamin deficiency and so on.

Frontal sinusitis clinical manifestations

Systemic symptoms

May have symptoms of loss of appetite, irritability, chills, fever, constipation, insomnia, and malaise.

Local symptoms

(1) Nasal symptoms The persistent nasal congestion on the affected side of the nasal congestion may be caused by swelling of the nasal mucosa or accumulation of nasal secretions in the nasal cavity; runny nose: nasal secretions are mucopurulent or purulent, often in the morning, often associated with Related to head drainage; diminished sense of smell.

(2) If there is a frontal osteomyelitis in frontal flow osteomyelitis, it can form a frontal flow pus fistula, mostly in the front wall of the frontal sinus and its bottom.

(3) Headache If the frontal sinus drainage is blocked, headache may occur, and there may be reflex headache in the trigeminal nerve distribution area. The symptoms of frontal sinusitis are headaches, beginning with total headaches, and gradually confined to the upper orbital angle and forehead of the affected side. The pain has a clear time pattern. It starts every morning and gradually worsens at noon. It is the most severe at noon and gradually relieves in the afternoon. The headache disappears at night and the attack repeats the next day. There was obvious tenderness in the upper corner of the orbit.

Frontal sinusitis examination

Local swelling

Mostly appear in children, red and swollen forehead and upper eyelid.

2. Tenderness and Buckling

The anterior or bottom wall of the affected frontal sinus has tenderness or throbbing pain.

3. Anterior Rhinoscopy

Congestion of the mucosa can be seen, and the frontal mucosa of the middle nail has redness and swelling or polypoid changes. There is purulent discharge before and above the middle nasal passage. The pus of maxillary sinusitis is mostly in the posterior and lower part of the middle nasal passage. The ethmoid sinusitis can be seen with purulent secretions in the middle nasal passage and olfactory fissure, which can be identified.

4. Head position test

When no purulent secretion is seen in anterior rhinoscopy, 1% ephedrine can be used to contract the middle turbinate and middle nasal tract mucosa, and then keep the head in the middle position for 5 minutes. Check the nasal cavity again to see if pus appears in the nasal passage. With maxillary sinusitis, maxillary sinus puncture and irrigation can be performed first to remove pus and then perform head drainage to determine the presence of frontal sinusitis.

5. X-ray of frontal sinus

Take the frontal and lateral positions of the nose, compare the bilateral frontal sinus transmittance, and judge the lesions. Asymmetry in bilateral frontal sinus size is normal and has nothing to do with the diagnosis of frontal sinusitis. A well-developed frontal sinus may have a bone septum, which is also normal.

6.CT scan

Coronal and axial scans can be used to show the size and extent of the frontal sinus, the condition of the anterior and posterior bone walls, and the pus in the sinus cavity.

Frontal sinusitis diagnosis

Ask a detailed medical history and analyze the condition carefully. Children may have redness and swelling in the forehead and upper eyelid. Ipsilateral frontal sinus has tenderness and throbbing pain. Nasal examination may have redness and swelling of the frontal mucosa of the middle nail and polyp-like changes. Purulent secretions can be seen in the middle nasal passage. Endoscopy should be performed to observe the source of pus. X-ray or CT examination. CT examination makes the diagnosis of sinusitis more convenient and straightforward.

Differential diagnosis of frontal sinusitis

Distinguish from acute rhinitis and other sinus inflammation.

Frontal Sinusitis Treatment

General therapy

Pay attention to rest, drink plenty of water, and symptomatic treatment of headaches and other symptoms.

2. Anti-inflammatory treatment

It is preferred to use penicillin antibiotics in sufficient quantities. For allergies or resistance, other broad-spectrum antibiotics should be used.

3. Local treatment

Nasal treatments include nasal mucosal vasoconstrictors and antibiotic nose drops, replacement surgery, and so on. Physical therapy such as ultrasonic nebulization, steam inhalation, and topical compresses can be used.

4. Surgery

Acute phase is not suitable for surgery. Used when sinus inflammation spreads out and causes serious complications in adjacent organs.

In the acute phase, the standard treatment can not be improved for more than 1 month or can be treated surgically. To improve the sinus ventilation and drainage, and promote the subsidence of sinus inflammation. Complementary surgery includes correcting the high curvature of the nasal septum, nasal polypectomy, and partial turbinate resection. Sinus Surgery: It is divided into traditional sinus radical surgery and functional nasal endoscopic sinus surgery which is currently widely used.

Frontal Sinusitis Prevention

1. Usually pay attention to nasal hygiene, develop good sanitary habits in the morning and evening.

2. Pay attention to the method of snotting. Those with nasal congestion and nasal discharge should press the nostril on one side of the nasal cavity and forcefully exfoliate. Alternate afterwards. Wash your nose with saline when your nose is too thick to avoid damaging your nasal mucosa.

3. When swimming, make sure your posture is correct and try to keep your head out of the water.

4. Patients with dental disease should be treated thoroughly.

5. During an acute attack, take more rest. The bedroom should be bright and maintain indoor air circulation. But avoid direct blowing and direct sunlight.

6. Follow the doctor's advice and take the medicine promptly.

7. Patients with chronic sinusitis should have confidence and perseverance in treatment, and pay attention to strengthen exercise to strengthen their physique.

8. Tobacco, alcohol and spicy food are strictly prohibited.