1. Complications of sinusitis Orbital Orbital Osteomyelitis of Maxilla and Frontal bone Osteomyelitis of Maxilla and Frontal bone Mucocele Mucocele Locoregional complications Locoregional complications Pharyngitis, laryngitis, otitis media Pharyngitis, laryngitis, otitis media Intracranial complications Intracranial complications Meningitis, intracranial abscess, cavernous sinus thrombosis Meningitis, intracranial abscess, cavernous sinus thrombosis

2. Orbital Complications Orbital cellulitis Orbital cellulitis Orbital abscess Orbital abscess Mode of Spread Mode of Spread Direct Direct Thrombophlebitis of vessels Thrombophlebitis of vessels Presentation Presentation Aching around the orbit Aching around the orbit Edema of conjunctiva Edema of conjunctiva Proptosis- later Proptosis- later Blindness Blindness Treatment- IV Abs and Nasal decongestants Treatment- IV Abs and Nasal decongestants

3. Orbital Complications Abscess Abscess Direct spread Direct spread Proptosis Proptosis Restriction of eye movements Restriction of eye movements Blindness Blindness Loss of red color vision before other colors and visual cauity Loss of red color vision before other colors and visual cauity CT scan CT scan Treatment Treatment Urgent drainage Urgent drainage

4. Osteomyelitis Occurs where there is diploic bone Occurs where there is diploic bone Maxailla in children and Frontal in adults Maxailla in children and Frontal in adults Maxilla Maxilla Painful swelling of the cheek and lower eye lid Painful swelling of the cheek and lower eye lid CT CT Treatment Treatment IV ABs and debridement IV ABs and debridement

5. Osteomyelitis…. Frontal Bone Frontal Bone Dangerous and more extensive. Dangerous and more extensive. Dull local pain and swelling of the upper eye lid. Dull local pain and swelling of the upper eye lid. Potts puffy tumor Potts puffy tumor High risk if intracranial complications High risk if intracranial complications Treatment Treatment IV ABs and debridement IV ABs and debridement

6. Mucocele Frontal, Ethmoid, Maxillary, Sphenoid Frontal, Ethmoid, Maxillary, Sphenoid Due to permanent blockage of the drainage Due to permanent blockage of the drainage collection of sterile mucous, gradually expands and causes erosion of sinus walls from pressure collection of sterile mucous, gradually expands and causes erosion of sinus walls from pressure Presentation Presentation Headache and swelling Headache and swelling Displacement of the eye ball Displacement of the eye ball Treatment Treatment Endoscopic vs open techniques for drainage Endoscopic vs open techniques for drainage Open techniques Open techniques Frontoethmoidectomy Frontoethmoidectomy Osteoplastic flap operation Osteoplastic flap operation

7. Locoregional Complications Generalized Pharyngitis Generalized Pharyngitis Granular Pharyngitis Granular Pharyngitis Tonsillitis Tonsillitis Laryngitis Laryngitis Otiis medias Otiis medias

8. Intracranial complications Complications arise form Complications arise form Frontal Frontal Etmoid Etmoid Sphenoid Sphenoid Mode of Spread Mode of Spread Direct Direct Retrograde thrombophlebitis Retrograde thrombophlebitis Meningitis- commonest Meningitis- commonest Intracranial abscess Intracranial abscess Extradural Extradural Subdural Subdural Cerebral Cerebral Encephalitis Encephalitis Cavernous sinus thrombophlebitis Cavernous sinus thrombophlebitis

9. Intracranial complications Meningitis Meningitis LP and C/S LP and C/S IV Abs IV Abs Cavernous Sinus Thrombophlebitis Cavernous Sinus Thrombophlebitis High fever with chills and rigors High fever with chills and rigors Edema of conjunctiva Edema of conjunctiva Proptosis Proptosis Ophthalmoplegia Ophthalmoplegia Blindness Blindness Reduced level of conciousness Reduced level of conciousness Death Death CT/MRI CT/MRI High index of suspician High index of suspician IV Abs IV Abs Intracranial Abscesses Intracranial Abscesses Surgical intervention by neurosurgeon Surgical intervention by neurosurgeon