COMPLICATIONS OF SINUSITIS

When the disease progress and extend beyond the sinuses, that means complications has set in , be it from acute or chronic sinusitis. 

WHO ARE PRONE FOR COMPLICATIONS  ? 

Usually children and young adults  because of the thin bony walls of the sinus and the septum. Other factors  are like low immunity, virulence of the infective  bacteria, structural abnormalities of the nose and sinusitis, close relationship of orbit ( eyeball and socket) with the  paranasal sinus, and skull bone with brain. 

MECHANISM OF SPREAD

Infection can spread through the blood and reach adjacent structures, or through bony defect or natural foramina or canal for the passage of blood vessels and nerves. Veins  of the nose have connection with that of dura ( outer covering of brain), so infection spread to the brain from the sinus especially frontal and ethmoid sinuses. 

WHAT ARE THE COMPLICATIONS  ? 

Orbital, intracranial, bony and chronic complications. 

ORBITAL or EYE  complications  manifest as eye swelling, pus or cellulitis  involving the eyelids and orbital contents, double vision , opthalmoplegia ( weakness or paralysis of eyeball muscles) and other symptoms.. If not treated immediately, vision loss ( blindness) and spread to dangerous area like cavernous sinus and brain occurs. Cavernous sinus if involved ,both eyes will be affected and patient will be having high fever ,chills and rigor . 

INTRACRANIAL COMPLICATIONS

Brain  involvement may manifest as headache, fever,  neck stiffness ( meningitis) seizure, drowsiness, double vision and eyepain, 

BONY COMPLICATIONS

Frontal bone over forehead when  affected, there will be osteomyelitis or abscess ( pus collection). Maxillary  bone over the cheek if involved can result in pus collection, osteomyelitis and formation of oroantral fistula, which is a connection between maxillary antrum and oral cavity. 

Other  complications are laryngitis, pharyngitis, bronchitis, ear infection

Mucocele which is a progressive cystic swelling develops as a complication of chronic sinusitis. 

HOW DO YOU MANAGE   ? 

Detail history of illness and Radiological investigations to be done  ,manage according to the area involved. Pus has to be drained. Broad spectrum antibiotics to be given. Supportive treatment also needed. 

THIS POST WAS WRITTEN TO MAKE YOU AWARE OF THE COMPLICATIONS THAT CAN ARISE FROM A SINUSITIS.