Frontal sinus infection

and Carola Felchner, science journalist

Martina Feichter studied biology with an elective subject pharmacy in Innsbruck and also immersed herself in the world of medicinal plants. From there it was not far to other medical topics that still captivate her to this day. She trained as a journalist at the Axel Springer Academy in Hamburg and has been working for since 2007 - first as an editor and since 2012 as a freelance writer.

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Carola Felchner is a freelance writer in the medical department and a certified training and nutrition advisor. She worked for various specialist magazines and online portals before becoming a freelance journalist in 2015. Before starting her internship, she studied translation and interpreting in Kempten and Munich.

More about the experts All content is checked by medical journalists.

Frontal sinus inflammation (medical sinusitis frontalis) is a form of sinusitis: The mucous membrane in one or both frontal sinuses is inflamed. Sufferers typically have severe pain in the forehead area and severe runny nose. The disease can be acute or chronic and occur at any age. Read more about the symptoms, causes, and treatment of frontal sinus infection.

ICD codes for this disease: ICD codes are internationally recognized codes for medical diagnoses. They can be found, for example, in doctor's letters or on certificates of incapacity for work. J01J33

What is frontal sinus infection?

Frontal sinusitis is a rarer form of sinusitis. Sometimes it appears in isolation. In other cases, the lining of one or more of the other sinuses is also inflamed. For example, the frontal sinus infection can be accompanied by inflammation of the ethmoid cells (ethmoid sinusitis). Sometimes all of the sinuses are also inflamed. Then doctors speak of pansinusitis.

Frontal sinusitis: causes

The causes of a frontal sinus infection include a chronic ventilation disorder of the frontal sinus - for example with severely stunted nasal septum or nasal polyps. Infections in the nose area and swimming pool visits ("bath sinusitis") can also trigger frontal sinusitis. The causative agents of the inflammation are often bacteria (such as Streptococcus pneumoniae) or viruses, sometimes also fungi. Allergies can also cause the inflammation.

Frontal sinusitis: symptoms

In acute frontal sinusitis, severe, stabbing, pulsating or boring pain develops over the affected frontal side and around the eye within a few hours. The discomfort increases when the patient bends his head forward, sneezes, or coughs. The inflamed area also reacts sensitively to touch. Other possible symptoms of acute frontal sinus infection are slimy-purulent runny nose, an impaired sense of smell and pain when chewing. If the inflammation spreads towards the eye, conjunctivitis can develop.

Symptoms of chronic frontal sinus inflammation are rather uncharacteristic: headaches in the sense of dull tension or chronic headache on the half-side of the forehead are part of it. In addition, odors are reduced or perceived incorrectly (hyposmia or cacosmia). It can also form slimy-purulent nasal secretions.

The forehead pain typical of acute frontal sinus inflammation occurs in the chronic course, i.e. if the disease lasts longer than twelve weeks, less severe or (almost) not at all.

Possible complications of frontal sinusitis are, for example, swelling or abscess formation in the area of ​​the upper eyelid, purulent inflammation of the eye socket (orbital phlegmon), meningitis and brain abscess.

Frontal sinusitis: diagnosis

First, the doctor collects the medical history (anamnesis): He asks the patient, among other things, about the type, extent and duration of the complaints.

This is followed by a physical and ENT medical examination: the doctor taps, for example, the front wall of the frontal sinuses. He also asks the patient to quickly bend the upper body forwards or hop on one leg - both of these trigger pain in the case of a frontal sinus infection or intensify existing pain. The doctor examines the inside of the nose by means of a nasoscopy (rhinoscopy): In the middle nasal passage, traces of mucus and pus can be found in the case of a frontal sinus infection.

In addition, the doctor examines the eyes. Among other things, he pays attention to water retention in the upper eyelid (upper eyelid edema) and signs of conjunctivitis.

With the help of an imaging process, the paranasal sinuses are shown more precisely, for example by means of an X-ray examination or - even better - computed tomography (CT).

In individual cases it can also be useful to examine a pus smear and / or a blood sample in the laboratory. In the case of chronic frontal sinus inflammation and a corresponding suspicion, an allergy test is also carried out.

If the doctor suspects that the frontal sinus infection has led to inflammation of the bone marrow of the frontal bone (frontal bone osteomyelitis), the metabolic activity of the bone tissue is examined. This is done by means of a nuclear medicine examination (either bone scintigraphy or SPECT). If other complications are suspected, appropriate examinations are carried out for clarification. If there are indications of meningitis, for example, the doctor takes some cerebrospinal fluid (CSF puncture) and has it analyzed in the laboratory.

Frontal sinusitis: treatment

As with other forms of sinusitis, treatment for frontal sinusitis aims to restore the drainage of secretions and restore ventilation to the affected sinuses. For this purpose, decongestant and expectorant drugs are used, as well as - in the case of bacterial infections - antibiotics, if necessary.

If this conservative treatment cannot sufficiently relieve the symptoms of the inflammation of the frontal sinus, the frontal sinus is opened at the level of the eyebrows with a drill (Beck drilling). So you can suck off secretions and pus and flush the cavity with antibiotics.

Frontal sinus infection: home remedies

In addition to conventional medical measures, home remedies can also support the healing process in the case of a frontal sinus infection (or other form of sinusitis). For example

• Inhalations
• Saline nasal drops
• Medicinal herbal teas
• red light
• Wraps & Envelopes
• Foot baths

You can read more about this in the article "Sinusitis: Home Remedies".

In addition, some patients use homeopathy, Ayurveda, and other complementary healing methods for sinusitis. Those who are interested should seek advice from an experienced therapist.

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