Sinusitis frontalis is an inflammation of the sinus cavity. It is a form of sinusitis.
What is frontal sinusitis?
In frontal sinusitis, the frontal sinus is inflamed. The frontal sinus is a sinus cavity. Inflammation of a sinus cavity is called sinusitis. The frontal sinus is called sinus frontalis in Latin, so the inflammation of the frontal sinus is called sinusitis frontalis in medical terminology. In sinusitis, the mucous membrane in the sinuses is inflamed. Normally, the mucous membrane of the nose is also inflamed. A combination of inflammation of the nose and inflammation of the sinuses is called rhinosinusitis. The two sinuses are located just above the nose above the eyebrows. Therefore, sinusitis frontalis results in a headache in the frontal area. Inflammation of the frontal sinus can occur in isolation or in combination with inflammation of the other sinuses. Most commonly, the maxillary sinuses are inflamed. Ethmoidal sinusitis is also quite common. Isolated sinusitis is less commonly found. Sinusitis frontalis can be distinguished between an acute and a chronic form. Acute sinusitis lasts a maximum of two weeks. After this time, the symptoms have completely disappeared. If the disease lasts longer than two weeks or symptoms remain, it is a chronic sinusitis frontalis.
Causes
Acute suppuration of the sinus usually develops from a cold (rhinitis). Swelling of the mucous membranes in the nose obstructs the drainage of secretions from the sinus. Only 20 to 30 percent of all sinusitis is caused by bacteria. The majority are caused by viruses. However, once viral sinusitis has developed, pathogens such as Haemophilus infulenzae B, pneumococci or ß-hemolytic group A streptococci readily cause a secondary bacterial infection. Allergy may also cause frontal sinusitis. Chronic sinusitis frontalis usually results from an unhealed acute sinus infection. Several factors can contribute to sinusitis frontalis developing more quickly. Possible risk factors include a weakened immune system and anatomic features such as enlarged turbinates, narrowed entrances to the sinuses, and a bent nasal septum.
Symptoms, complaints, and signs
The leading symptom of acute sinusitis is headache. These are accompanied by a strong feeling of pressure in the front of the head. The pain worsens as soon as the affected person tilts the head forward. The pain is also aggravated by jarring, such as when jumping or stepping firmly with one foot. Often, the pain throbs just above the eyebrows. When sinusitis occurs in combination with maxillary sinusitis, toothache may also develop. If rhinitis occurs at the same time, a purulent yellowish-green nasal secretion develops. Nasal breathing is impeded, and a so-called “mucus street” forms in the throat. This is caused by the constant flow of secretion from the sinuses. The secretion cannot drain through the nose and thus runs down the throat. Severe inflammation is accompanied by fever, visual disturbances and fatigue. A severe cough can also result from the mucus running down the respiratory tract. If the cough is prolonged, there is pain in the chest muscles. Chronic sinusitis is characterized by a loss of efficiency and by chronic fatigue. In advanced stages, drowsiness and even delirium may develop. Sinusitis frontalis is not normally associated with nosebleeds. Increased nosebleeds should always be considered as an indication of a malignant neoplasm in the paranasal sinuses.
Diagnosis and course of the disease
The diagnosis can be made easily with endoscopic examination. The rather clear symptomatology of sinusitis usually already provides the decisive clues. Imaging techniques such as sonography or magnetic resonance imaging can be used to clarify chronic sinusitis.
Complications
Sinusitis frontalis can cause various complications.Occasionally, for example, abscesses form in the area of the upper eyelid or purulent inflammation of the eye socket occurs. In a severe course, life-threatening meningitis and brain abscesses can develop. If frontal meningitis is not treated or is treated inadequately, it can develop into a chronic disease. This may be accompanied by olfactory and gustatory disturbances. Some patients suffer from acute episodes of infection accompanied by pain and fatigue. Typical symptoms such as fever or cough can also lead to serious complications, such as circulatory problems and respiratory distress. In the advanced stage of the disease, there may be persistent drowsiness and even delirium. Increased nosebleeds indicate that the inflammation has spread to the sinuses. If medications are prescribed as part of the therapy, various side effects and interactions may occur. For example, the use of decongestant nasal sprays or nasal drops can cause irritation to the mucosa or even lead to dependence. Antibiotics and expectorants sometimes cause complaints such as gastrointestinal problems, headaches or allergic reactions. With prolonged use, heart, liver and kidney damage can also not be ruled out.
When should you see a doctor?
Frontal sinusitis is not always a reason to see the doctor. Often it arises on the basis of a bacterial infection and heals spontaneously together with it. Nevertheless, there are cases that make it necessary to go to the doctor. This can be the initial diagnosis of the disease as well as the treatment of chronic sinusitis or a clinical picture with particularly severe symptoms. In these cases, the contact persons are the family doctor or the specialist for ear, nose and throat medicine. Sinusitis frontalis requires a visit to the doctor in particular when pressing headaches occur above the eye area in connection with a cold or a cold simply does not want to heal. On the one hand, the doctor must establish that the headache is caused by a sinus infection and not by another process. On the other hand, it should be prevented that an acute disease takes a chronic course, which may then no longer be so easy to treat. Patients who are prone to sinusitis can also detect the disease in advance and prevent it from developing by going to the doctor. This is especially important for patients with multiple illnesses or for children who are repeatedly infected with bacterial infections by spending time in kindergarten and school.
Treatment and therapy
The main goal of therapy is to reduce inflammation. Natural mucus drainage in the nose and sinuses must be restored. Increased fluid intake through increased drinking liquefies the mucus and thus leads to improved elimination. The same effect is achieved by high humidity in the breathing air, by short-wave treatment, by nasal rinses or by seawater sprays. Steam inhalations with essential oils or plant extracts can also be helpful. Expectorants or mucolytic agents such as acetylcysteine or ambroxol can be taken. Mucolytic herbal preparations or enzyme preparations are also available for the treatment of frontal sinusitis. The use of mucosal decongestant nasal sprays or nasal drops may help relieve symptoms. Because dependence can develop quickly with these nasal sprays, the duration of use should be limited to one week. Medicines containing myrtle or cineole also ensure a clear nose. Enzyme preparations or nasal sprays containing cortisone can reduce inflammation. Antibiotics are indicated only in very severe symptoms. In addition, a bacterial infection should be considered confirmed or at least probable. In severe cases, surgical intervention may be required. Reduction of the size of the turbinate, bone scrapings, straightening of the nasal septum, or removal of polyps can facilitate obstructed mucus drainage. In frontal sinusitis, intense heat and severe cold should be avoided. Fluctuations in temperature increase the pain. If the headache is severe, the head can be elevated in bed by placing several pillows. This allows the secretion to drain more easily.
Prevention
At best, sinusitis frontalis can be prevented by strengthening the immune system. When you have a cold, you should only blow your nose with a little pressure. Otherwise, bacteria can enter the sinuses due to the high pressure. If the inflammation of the sinuses is due to benign mucosal growths or other anatomical conditions, these can be removed by surgery. This can prevent future inflammation.
Aftercare
In most cases, the measures of direct aftercare for sinusitis frontalis are significantly limited, in some cases not even being available to the affected person. Therefore, the affected person should ideally see a doctor very early in this disease and also initiate treatment to avoid further discomfort or complications. This disease cannot heal on its own, so treatment by a doctor is usually always necessary. The earlier a physician is contacted, the better the further course of the disease. In most cases, sinusitis frontalis can be treated well by taking medication. The affected person should always observe the correct dosage and regular intake in order to permanently alleviate the symptoms. When taking antibiotics, it should be noted that they must not be taken together with alcohol, as their effect will otherwise be reduced. After treatment, regular checks and examinations by a doctor are still very useful. Sinusitis frontalis does not usually reduce the life expectancy of the affected person.
What you can do yourself
In the acute form of the disease, there is a severe forehead headache. Likewise, one or both of the frontal sinuses are sensitive to pressure and tapping. In this case, the physician must determine whether it is necessary to give antibiotics. Self-help measures are not recommended in this case. In this case, it is better to consult the ENT physician. Self-help measures are recommended only in case of chronic sinusitis. Hydrotherapeutic measures include chamomile steam baths and warm rising foot baths. Steam inhalations with essential oils of spruce, lavender, and eucalyptus are also soothing and beneficial. A good self-help measure is the addition of essential oils to the bath water. To do this, add five to eight drops of peppermint oil to the bath water along with the same amount of lemon and lavender oil. Also helpful are rubs with one of the above oils, which should be mixed with 60 ml of a suitable carrier lotion for the face. Before going to bed, sufferers rub the cheekbones from the nose to the temples and forehead. Dry breathing air should be avoided, as it dries out the mucous membrane of the nose and throat. Walks in the fresh air and adequate hydration are suitable for supporting mucosal function.
