Acute frontal sinusitis after lacrimal surgery

Acute frontal sinusitis occurred in four patients who required removal of the anterior portion of the middle turbinate to provide adequate intranasal drainage during lacrimal surgery. Three patients with redness and swelling around the wound were initially thought to have wound infection, but localized tenderness to percussion of the frontal sinus and air fluid levels on x-rays indicated acute frontal sinusitis. Treatment with antibiotics and steroids gave relief. Use of unipolar electrocautery to excise the middle turbinate probably caused acute inflammation of the frontonasal duct. We recommend simple excision without electrocautery in those cases requiring removal of turbinate for successful lacrimal surgery.