Evaluation and Management of Chronic Frontal Sinusitis in Sweden

[Dr. Gopi Shah]
That's interesting. In terms of, now getting into our clinical topic, we're going to talk about chronic frontal sinusitis. How did these patients present to you? What symptoms do they usually have?

[Dr. Jens Andersson]
I knew this question was going to come and still I have a hard time answering it because they can actually come in any number of ways. They can obviously have had problems for a long time with headaches and stuffiness and nasal congestion and sometimes low-grade fever. Actually, this week I had a man who came I think originally from Bangladesh but he'd been in the healthcare system. He'd been seeing his GP for a while and then they referred him to the ophthalmology clinic and always it's easy when you are the last one seeing the patients. Sometimes I say that the most useful tool we have is the retrospectoscope. When we see something and we can tell, "Oh, okay, you should have seen this coming," and they didn't. He presented with a swollen right eye, and then when we did the CT scan, he had a severe frontal sinusitis with bony wall destruction to his right eye. Then also almost surprised that it wasn't a Potts puffy tumor because he had a destruction in his frontal table of the sinus and also actually a bit in the back and towards the intracranial space. He had been going with this for a long time. Actually, I think it was dental from the beginning because one of the biggest mucous seals in the maxillary sinus that I've seen. His teeth were not that good.