Sinusitis is considered to be a rather common entity in clinical practice, as studies show that up to 31 million diagnoses are made in the United States alone each year [1] [2]. Sinusitis may be classified according to the duration of symptoms (acute, subacute, chronic, or recurrent) and the etiology (bacterial, viral, or fungal) [1] [3] [4]. If symptoms last up to 4 weeks (or 30 days by some authors), the term acute sinusitis is used; when four or more episodes of acute sinusitis are seen during the year, the diagnosis of recurrent sinusitis can be made; and conversely, chronic sinusitis develops when symptoms last more than 90 days (or 12 weeks) [1] [3] [4] [5]. The clinical presentation of sinusitis (regardless of the exact sinus involved) is comprised of symptoms such as nasal obstruction, discharge, localized pain, and headaches [4] [5] [6] [7]. Some studies show that vomiting may be a common symptom as well [7]. However, the frontal sinusitis is suspected when a headache, described as constant and dull pain, is localized to the forehead or the superior aspects of the orbit [1] [4] [8]. Frontal sinusitis is known for causing intracranial complications, primarily because of its anatomical proximity to the meninges and the venous sinuses [1] [8] [9]. For this reason, an early diagnosis is mandatory.

• Low Fever

  Symptoms of a cold (runny nose and low fever) often give way to pain and pressure in the sinuses, which are usually the first signs of sinusitis. [humanillnesses.com]

• Wound Infection

  Three patients with redness and swelling around the wound were initially thought to have wound infection, but localized tenderness to percussion of the frontal sinus and air fluid levels on x-rays indicated acute frontal sinusitis. [ncbi.nlm.nih.gov]

• Pseudotumor

  In rare cases, the osteomyelitis of the frontal bone can be externally presented in the form of a subperiosteal abscess, which manifests itself clinically by infiltration and "pseudotumoral" bulging of the soft tissues in the anterior frontal region, [panafrican-med-journal.com]

• Frontal Sinus Pain

  It is characteristic of acute frontal sinus pain to show definite periods of occurrence each day. [jamanetwork.com]

  Maxillary sinus pain is typically felt in the cheeks and may be mistaken for pain in the upper molars. Frontal sinus pain is felt above the eyes and is often confused with tension headache. [allergic.net]

• Facial Mass

  The study of the facial mass was carried out by series of T2, T1 and T1Fat Sat weights with IV injection of Gadolinium. [panafrican-med-journal.com]

• Headache

  The symptoms may be minimal and may be manifested only by a mild headache and occasional stuffy nose. A 16-year-old boy was studied one month after a head injury sustained while wrestling, complaining only of recurrent headaches and fever. [ncbi.nlm.nih.gov]

  However, the frontal sinusitis is suspected when a headache, described as constant and dull pain, is localized to the forehead or the superior aspects of the orbit. [symptoma.com]

  To reduce the headache prescribed ibuprophen, amidopyrine. Apply calcium gluconate. [minclinic.ru]

  Treatment for these true “sinus headaches” may be medical, including antibiotics and/or steroids, or surgical, depending on the individual presentation. Tension Headache Cluster Headache Headache due to Rhinosinusitis A. [care.american-rhinologic.org]

• Frontal Headache

  CASE REPORT: A 21-year-old woman at 35 weeks' gestation presented with a history of frontal headaches and swelling, periorbital oedema, pain and chemosis. [ncbi.nlm.nih.gov]

  In our case, the patients had exophthalmos and frontal headache which are considered to be caused by extension of CB mucocele into the orbital space and acute frontal sinusitis secondary to the obstruction of osteomeatal complex by CB mucocele. [bmcresnotes.biomedcentral.com]

The workup of frontal sinusitis should start with a complete patient history that will include the duration of symptoms and their progression [1]. A presumptive diagnosis in terms of etiology can be made based on the duration of complaints, as viral sinusitis (rhinovirus, influenza virus and parainfluenza virus) is more likely when the illness lasts < 10 days, whereas bacterial pathogens (staphylococcus aureus, streptococcus pneumoniae, haemophilus influenzae, moraxella catarrhalis, etc.) should be considered with a prolonged clinical course [1] [6]. A thorough physical examination, comprised of cranial inspection, palpation of the sinuses (which reveals tenderness in the frontal area in the case of frontal sinusitis), and anterior rhinoscopy must follow in order to obtain sufficient evidence to make the diagnosis [1]. Imaging studies are recommended for solidifying clinical suspicion and plain radiography is the first-line study for sinusitis [1] [5]. The frontal view (known as Caldwell‐Luc view) is used to assess the frontal sinuses and can reveal opacification of the sinus or the presence of an air-fluid level [3] [5]. Computed tomography (CT), however, is a superior method that is able to provide a better view into the sinuses and their anatomical landmarks, which is why it is favored over X-rays [1] [3] [5]. In some patients, puncture of the frontal sinus might be indicated to obtain viable material for microbiological investigation, especially if fungal pathogens are suspected [3] [5].

• Periostal Elevation

  (A) Curved incision under eyebrow to periosteum, (B) underlying bone exposed by periosteal elevator, with burr holes created with small drill, (C) two small plastic tubes inserted for daily irrigation of the frontal sinus. [emedicine.medscape.com]

• Sinus Opacification

  New mucosal thickening of >1 mm was found in three patients in the MTsc group and eight patients in the MTsp group (p = 0.21); the only patient with postoperative complete frontal sinus opacification was in the MTsp group. [ncbi.nlm.nih.gov]

Results of treatment in the series support the opinion that combined aggressive surgical and antibiotic treatment is a preferred method in complicated sinusitis in children. [ncbi.nlm.nih.gov]

OF ACUTE FRONTAL SINUSITIS. ( 14179757 ) Glasscock M.E. 1964 26 Acute frontal sinusitis; complications and treatment. ( 13393906 ) KRATZ R.C....THORNELL W.C. 1957 27 The treatment of acute frontal sinusitis. ( 14362339 ) Brown J.M....GOODHILL V. 1955 [malacards.org]

Our conclusion was that the prognosis of frontal sinusitis is difficult to predict with any single factor, but is affected by many of them. [ncbi.nlm.nih.gov]

Treatment and Prognosis The treatment may be either medical or surgical. The initial treatment involves administration of appropriate antibiotics along with an analgesic and an anti-histaminic. [webhealthcentre.com]

The prognosis is guarded. The best control method is to dehorn calves at a young age using a closed dehorning technique. [merckvetmanual.com]

Treatment and prognosis In general, drainage and marsupialisation of an affected sinus are sufficient. If large bony defects are present, reconstructive surgery may be necessary (e.g. of the orbital floor). [radiopaedia.org]

Prognosis The prognosis for acute sinusitis is very good. Most cases will go away within one to two weeks, often without antibiotics. [drugs.com]

Sinusitis may be classified according to the duration of symptoms (acute, subacute, chronic, or recurrent) and the etiology (bacterial, viral, or fungal). [symptoma.com]

Although anatomic variations in the frontal recess are likely to play a role in frontal sinusitis, mucosal inflammatory processes are likely to be a much more important etiologic factor. [ncbi.nlm.nih.gov]

Etiology and pathogenesis INFLAMMATION OF THE FRONTAL SINUS (SINUSITIS FRONTALIS ACUTA ET CHRONICA) Infection. [lecheniebolezni.com]

Aim: The purpose of this study is to evaluate epidemiology, clinical features and management of the frontal sinusitis’s complications. Study Design: Retrospective study. [scitechnol.com]

Epidemiology Although this is less common than acute sinusitis, it remains a reasonably common entity in itself, accounting for about 25 cases per 10,000 person-years in an average UK GP practice [ 2 ]. [patient.info]

Thorough discussions of anatomy and pathophysiology of a variety of frontal sinus diseases provide a background for in-depth chapters on aspects of both medical and surgical management. [books.google.es]

In order to understand the pathophysiology of chronic frontal sinus infections it is imperative that we should understand the anatomy of frontal outflow tract. Complications are more common in chronic frontal sinusitis. [drtbalu.co.in]

The pathophysiology of frontal sinusitis is associated with ventilation of the sinus via the sinus ostium. The size of the frontal sinus ostium is key to frontal sinus drainage. [journalotohns.biomedcentral.com]

[…] chronic bronchitis, exacerbation of these diseases affects more than 90 million people—nearly one in three Americans. 5 The socioeconomic impact of this translates to more than $5.8 billion dollars spent on the treatment of sinusitis. 6 Back to Top Pathophysiology [clevelandclinicmeded.com]

It can occur as a result of a variety of causes of inflammation, the pathophysiology being that this leads to sinus cavity obstruction and subsequent infection (acute sinusitis) and chronic inflammation (chronic disease). [patient.info]

Surgical intervention is often required to prevent unacceptable mortality. [ncbi.nlm.nih.gov]

How Can Frontal Sinusitis be Prevented? Practicing good hygiene is the best way to prevent Frontal Sinusitis. [epainassist.com]

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2. Lethbridge-Cejku M, Rose D, Vickerie J. Summary health statistics for US adults: National Health Interview Survey, 2004. Vital Health Stat. 2006;10:19-22
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4. Porter RS, Kaplan JL. Merck Manual of Diagnosis and Therapy. 19th Edition. Merck Sharp & Dohme Corp. Whitehouse Station, N.J; 2011
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6. Jones NS. Sinus headaches: avoiding over- and mis-diagnosis. Expert Rev Neurother. 2009;9(4):439-444.
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8. Reuler JB, Lucas LM, Kumar KL. Sinusitis. A review for generalists. West J Med. 1995;163(1):40-48.
9. Hadley JA, Schaefer SD. Clinical evaluation of rhinosinusitis: history and physical examination. Otolaryngol Head Neck Surg 1997;117(Suppl): S8 –S11.