Head and Neck Imaging

Frontal sinus, pathology

Inflammatory changes are commonly seen in the frontal sinus (see sinonasal cavities, inflammation ). While orbital complications are more common with ethmoid sinusitis, intracranial complications (albeit rare) more often originate from frontal sinusitis because of a rich vascular network connecting the posterior sinus mucosa with the meninges. Bone destruction due to osteomyelitis is also most often seen in the frontal sinus (see Pott's puffy tumor ).
Mucocele
The frontal sinus is the most common location for a mucocele . The sinus appears radiologically as an expanded airless cavity. Apart from frontal bossing, it may cause deformity of the adjacent orbit; intracranial extension of a frontal mucocele may be seen.Frontal fractures are the result of a direct trauma, or extension of a calvarial fracture. A posterior wall fracture may be complicated by cerebrospinal fluid leak , a pneumocele, meningitis or contusion to the frontal brain parenchyma. Also, see facial fracture .
Tumoural pathology
The frontal sinus is the most common location for sinonasal osteoma (see osteoma, sinonasal ).
Primary frontal sinus carcinoma is rare. Frontal bone erosion occurs rapidly, with spread into the adjacent structures (Fig. 1). The prognosis is poor. Also, see sinonasal cavities, cancer .

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Fig. 01a

Contrast-enhanced axial CT image. Tumoral lesion in the frontal sinus, causing bone erosion, and growing both intra- and extracranially. Squamous cell carcinoma.
Frontal sinus, pathology, Fig. 01a