Complications
Although rare, infection related to rhinosinusitis can spread to the eye, leading to periorbital cellulitis/preseptal edema, orbital cellulitis, subperiosteal abscess, or orbital abscess. The clinician must have a low threshold of suspicion for these potential complications.[2] Rapid diagnosis and treatment is recommended.[2]
Although rare, cavernous sinus thrombosis can occur, particularly in the setting of infection that has spread to the orbit. The clinician must remain alert to this possibility.
Rarely, infection associated with rhinosinusitis can penetrate surrounding bone and cause osteomyelitis.
This consists of a subperiosteal abscess in association with necrotic osteomyelitis of the frontal bone.[2] It presents as a tender doughy soft tissue swelling on the forehead.
Rarely, infection associated with rhinosinusitis can spread intracranially, potentially causing an epidural abscess, subdural empyema, meningitis, cerebral abscess, or dural-vein thrombophlebitis. May present with nonspecific symptoms; requires high clinical suspicion, especially in children.[2]
A rare complication of rhinosinusitis.
A rare complication of rhinosinusitis.
Rarely, infection related to rhinosinusitis and polyps can cause septicemia.
If polyps become sufficiently enlarged, it is possible for displacement of the globe to occur, which can cause visual disturbance.
Topical corticosteroids are associated with minor nasal bleeding in a small proportion of patients. Studies do not show any detrimental structural effects on the nasal mucosa with long-term administration. The systemic bioavailability is low and the dose administered is small, but judicious choice of formulation is wise especially if other corticosteroid medications are administered concurrently.
The systemic adverse effects of oral corticosteroids must be considered. Short courses are preferable, but if long-term treatment is necessary, patients should be monitored.
Includes orbital emphysema, ecchymosis of the eyelid, orbital hematoma, loss of visual acuity/blindness, diplopia, enophthalmos, and nasolacrimal duct damage.
Cerebrospinal fluid (CSF) leak, tension pneumocephalus, encephalocele, brain abscess, meningitis, intracranial bleeding, and direct brain trauma are rare potential complications of sinus surgery.
Rarely, sinus surgery can cause damage to the arterial supply of the nose.
Includes synechiae, hyposmia, osteitis, atrophic rhinitis, toxic shock syndrome, anosmia, and death.
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