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Acute frontal sinusitis after lacrimal surgery.

R E Wesley, W H Ballinger

Annals of Ophthalmology

|December 1, 1986

Summary

Acute frontal sinusitis can occur after middle turbinate removal during lacrimal surgery. Avoiding electrocautery during turbinate excision may prevent this complication.

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Area of Science:

Otolaryngology
Ophthalmology
Surgical Complications

Background:

Lacrimal surgery sometimes necessitates middle turbinate resection for adequate intranasal access.
Acute frontal sinusitis is a potential complication following nasal and sinus procedures.

Observation:

Four patients developed acute frontal sinusitis post-lacrimal surgery involving middle turbinate removal.
Symptoms included localized frontal sinus tenderness and radiographic air-fluid levels, initially mimicking wound infection.

Findings:

Unipolar electrocautery used for turbinate excision is the likely cause of frontonasal duct inflammation, leading to sinusitis.
Antibiotic and steroid therapy effectively resolved the sinusitis in affected patients.

Implications:

Simple turbinate excision without electrocautery is recommended to prevent acute frontal sinusitis after lacrimal surgery.
This surgical modification can improve patient outcomes and reduce the incidence of postoperative complications.

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