Inflammation of the lining of the air filled spaces within the forehead between and behind the eyes and within the cheeks often occurs after a cold or flu-like illness. It is commoner in adults as the sinuses are not fully developed until the age of 12 but it can occur in children who are particularly at risk of eye complications.
The main problem is blockage to the drainage/ventilation channels to the nose leading to a build up of secretions within the sinuses and infection. This occurs due to a cold or flu-like illness, allergy, nasal polyps, asthma, adenoids, a deviated nasal septum (twisting of the nasal partition inside) or an underlying disorder of the immune system.
Forehead or cheek pressure or pain particularly after straining is common. Nasal symptoms of obstruction, discharge, post nasal drip and impaired smell or taste occur but the throat can also be involved as a cough, foul smelling breath, hoarseness, sore throat or worsening of asthma. The complication of spread of infection to the eye and brain is fortunately rare but can occur in children and neglected cases.
Examination with a thin fibre optic endoscope can identify red swollen nasal lining, pus and crusts. A deviated nasal septum or nasal polyps will also be seen. CT scans identify the site and extent of the disease and where complications are suspected MRI images are helpful. Other investigations including assessment of the allergy and immune systems may be appropriate.
Nasal decongestants can open up the nasal passages. Saline douches wash out secretions and crusts, and antibiotics for up to 6 weeks may be effective.
Surgery is indicated where non-operative treatment has failed. The aim is to open up the ventilation draining channels to allow recovery of the lining of the sinuses and is performed using minimally invasive surgical techniques involving the passage of endoscopes and instruments into the nose via the nostrils only. Patients will return home the same day.