What is frontal sinusitis?

Frontal sinusitis is an inflammation or infection of the frontal sinuses, which are the air-filled cavities located just behind the forehead. It is a type of sinusitis (also known as a sinus infection) and can cause significant discomfort, especially around the forehead and eyes.

It may be acute (short-term) or chronic (long-lasting).

What causes frontal sinusitis?

Frontal sinusitis is typically caused by:

• Viral infections (such as the common cold)
• Bacterial infections
• Allergies
• Nasal polyps or structural blockages (e.g., deviated septum)
• Fungal infections (rare, but more likely in immunocompromised individuals)

These causes lead to swelling in the sinus lining, blockage of mucus drainage, and buildup of pressure in the frontal sinus.

What are the symptoms?

Common symptoms of frontal sinusitis include:

• Forehead pain or pressure, often worse when leaning forward
• Headache, especially in the front of the head
• Nasal congestion
• Postnasal drip
• Thick nasal discharge (yellow or green)
• Fever (especially in bacterial cases)
• Fatigue
• Loss of smell
• Tooth or facial pain

Symptoms of chronic frontal sinusitis may be milder but last longer than 12 weeks.

How is frontal sinusitis diagnosed?

A diagnosis is typically made through:

• Physical exam, including a check of nasal passages
• Patient history, focusing on symptoms and duration
• Nasal endoscopy, a small scope used to look inside the nose
• CT scan, if chronic sinusitis is suspected or complications are possible
• Sinus culture, in recurrent or resistant cases

What are the treatment options?

For acute frontal sinusitis:

• Saline nasal irrigation to clear the sinuses
• Decongestants (short-term use only)
• Nasal corticosteroid sprays to reduce inflammation
• Pain relievers (acetaminophen or ibuprofen)
• Antibiotics, only if symptoms persist beyond 10 days or worsen (suggesting bacterial infection)

For chronic or recurrent sinusitis:

• Longer-term nasal steroids
• Treatment for underlying allergies
• Sinus surgery (such as functional endoscopic sinus surgery, or FESS) may be needed to open blocked sinuses

Are there complications?

While most cases resolve without issue, untreated or severe frontal sinusitis can lead to complications such as:

• Orbital cellulitis (infection around the eye)
• Frontal bone osteomyelitis (bone infection, rare)
• Intracranial infections, such as meningitis or brain abscess (very rare but serious)

These are medical emergencies and require immediate treatment.

How can it be prevented?

Preventive tips include:

• Managing allergies properly
• Using humidifiers in dry environments
• Avoiding smoking and secondhand smoke
• Practicing good hand hygiene
• Staying hydrated
• Treating colds early to reduce risk of sinus blockage

When should someone see a doctor?

Consult a healthcare provider if:

• Symptoms last more than 10 days without improvement
• Pain is severe or worsening
• There’s swelling around the eyes or forehead
• High fever is present
• Sinus infections are recurring or chronic