- Etiology: Bacterial infection of the paranasal sinuses
- Imaging: Sinus can have mucosal thickening, air fluid levels, complete opacification, bony destruction
- DDX:
- Complications:
— Anatomic compartments involved
— Orbital complications – Up to 75% of complications
— Intracranial complications – Up to 20% of complications
— Surrounding tissues (Frontal scalp, pre and post maxillary fat, infratemporal and pterygopalatine fossa)
— Tissue involved
— Soft tissue – Cellulitis, abscess
— Bone – Osteitis, osteomyelitis
— Nervous tissue – Neuritis, cerebritis, infarction
— Vascular – Vascular occlusion, pseudoaneurysm
— Intracranial complications – Subtle pneumocephalus may be only sign
— Meningitis
— Epidural abscess is most common complication arising from middle ear or mastoid infection / subdural abscess
— Cerebritis / cerebral abscess
— Infarction – Venous thrombosis, angioinvasive disease / infarction, pseudoaneurysm
— Pott Puffy tumor
— Acute mastoiditis and coalescent mastoiditis
— Bezold abscess – Subperiosteal abscess / phlegmonous debris in soft tissues of neck
— Cavernous sinus thrombosis
— Venous sinus thrombosis - Treatment:
- Clinical: