Frontal sinus (sinus frontalis)

introduction

The frontal sinus (Frontal sinus) belongs to the paranasal sinuses like the maxillary sinus, the sphenoid sinus and the ethmoid cells (Paranasal sinus). It represents an air-filled cavity in the bone that forms the forehead and, like the rest of the paranasal sinuses, can also become inflamed, which is referred to as frontal sinus inflammation (see below).

anatomy

The Frontal sinus consists of two separate caves in the Frontal bones (Frontal bone) lie. The Frontal sinus is thus above the nasal cavity and also above the Eye sockets (Orbits) localized. Your back wall already borders on the front Skull base. In the interior is the paired Frontal sinus covered by mucous membrane, which is covered with small, mobile hairs on its surface, comparable to the nasal mucous membrane (Ciliated epithelium). The task of these hairs is to transport foreign bodies and dust particles that have entered the frontal sinus towards the nose. Towards the nasal cavity there is a small crescent shaped connection (Semilunar hiatus) that are in the middle nasal passage flows out. The bone in which the frontal sinus sits ensures the stability of the skull and thus protection of the brain. The frontal sinus serves here Lightweight construction of the bone, because without this air-filled cavity the bone would be very heavy and the head could not be lifted. Another function of the frontal sinus is to provide a Resonance space for the Voice training and thus to give the voice its individual sound and character. Furthermore, the well-perfused mucous membrane of the frontal sinus should be able to breath air moisten and heat. The frontal sinus is not present from birth but is only formed in the course of life. It has only reached its final shape when the skull has finished growing (usually between the ages of 20 and 25). This explains why toddlers can't get sinus infections just yet. Since the frontal sinus only develops in the course of adolescence, it is not surprising that there is a high degree of variability in the shape and appearance of the frontal sinuses from person to person. The two caves are often of different sizes.

The frontal sinus infection

A Frontal sinusitis (Frontal sinusitis) can be further divided into an acute and a chronic form.

causes

The underlying cause of both acute and chronic sinusitis is one Ventilation disturbancewith subsequent bacterial infection associated with the sinuses. In the acute Form of inflammation that, by definition, lasts less than 30 days sniff the main cause. The narrow passage between the frontal sinus and the nasal cavity is blocked by viscous nasal secretions, so that it becomes a Drainage disorder of the mucus comes from the frontal sinus. Bacteria settle in the viscous mucus and can lead to inflammation of the frontal sinus. Often the chronic form of the frontal sinus infection, which lasts over 90 days, is one of them acute sinusitis that has not healed properly. Other causes leading to constant ventilation disorder of the sinuses and thus too chronic frontal sinusitis lead, are anatomical conditions. One example of this is a strong one Curvature of the septumwhich makes adequate ventilation of the frontal sinus difficult. Also come extreme close ties between the frontal and nasal cavities, which can be relocated quickly. Other causes are Polyps, so benign mucosal growths, or also Tumorsthat obstruct the duct and thereby promote sinusitis. Other risk factors for a frontal sinus infection are Allergiesaffecting the nasopharynx or in general Weakened immune systemwhich leads to increased infections that cannot be fought as effectively as is the case with a healthy immune system.

Symptoms

The main symptom of a frontal sinus infection is an unusually long-lasting runny nose, which is usually very strong a headache in the area of ​​the forehead or the eyes. This headache is usually perceived as a pressing pain that is aggravated when bending forward, for example when tying your shoes. There is also often a pain over the frontal sinus To press or light tapping trigger. Pain can accompany the jaw and occur in the cheek area, causing the Chewing painful is affected. Since the frontal sinus is a Resonance space represents the voice, for whose individual sound is partly responsible, the voice usually sounds different when the frontal sinus is relocated. Also can The sense of smell and taste at a Frontal sinusitis be impaired. In the inflamed sinus can become pus to accumulate (Empyema), which can also make the nasal secretions purulent. As is typical of an infection, acute sinusitis is often accompanied by fever and fatigue. In the chronic form, there is no fever, but it does permanent feeling of pressure in the head and one permanently blocked nose with purulent secretion and often one too decreased odor perception (Hyposmia).

Particular dangers in frontal sinus inflammation are their close proximity to the eye socket and the brain, which in rare cases leads to Spread of inflammation can come to these structures. A so-called Orbital phlegmon or one Meningitis (meningitis) can be the result. It is therefore very important to consult a doctor to clarify the causes and further treatment if symptoms of frontal sinus infection have not improved after a few days.

diagnosis

The frontal sinus inflammation is diagnosed by the anamnese, in which, among other things, the Duration of the runny nose and the Characteristic of headache. During the clinical examination, the doctor will check whether the frontal sinuses are painful for tapping, which is indicative of a frontal sinus infection. At chronic Form of inflammation is caused by a smear Nasal secretions obtained, which are then applied to the laboratory Pathogen is examined, whereby a therapy tailored to the pathogen can then be initiated. If bacteria are not the cause of the sinus infection and an allergy is suspected, a Allergy test carried out. If the symptoms persist despite treatment, a referral will be made to ENT doctor, the one Nasoscopy can perform and look closely at the nasal mucosa. If the cause of the inflammation cannot be found out or if a tumor is suspected, come imaging measures like for example the Computed Tomography for use.

For more information, see: Frontal sinusitis

therapy

When you have a frontal sinus infection, it is important to yourself save and bed rest to be observed. The aim of treatment is to break through nasal secretions misplaced connection between the frontal and nasal cavities again continuously close. This can be achieved with Expectorants, temporary use of Nasal spraysthat to Swelling of the mucous membrane contribute and through inhalation With essential oils. It is also very important to get adequate amounts drink (at least two liters daily) so that the mucus becomes more fluid and can drain off better. Bacteria come to fight the infection Antibiotics for use. Can be symptomatic Painkiller how Ibuprofen and Paracetamol which, in addition to relieving pain, fight inflammation in the body. In rare cases, depending on the cause, there is also one surgery necessary, for example when straightening a Curvature of the septum or one Polyp removal.

forecast

The acute sinusitis mostly heals within 30 days without further complications. In the chronic inflammation the prognosis depends on the underlying cause.

prophylaxis

The best prophylaxis for a frontal sinus infection is a well-functioning immune systemthat effectively fights pathogens. This is also achieved by adequately treating and adjusting previous illnesses such as allergies.