What Are the Symptoms of Frontal Sinusitis?

Frontal sinusitis can be classified into acute and chronic forms. Acute frontal sinusitis is an acute suppurative sinusitis—a type of acute suppurative infection affecting the sinus mucosa. If acute frontal sinusitis is not promptly or properly treated, severe mucosal damage may occur, resulting in loss of normal mucosal function and progression to chronic inflammation. So, what are the clinical manifestations of frontal sinusitis? The following section addresses this question.

What Are the Symptoms of Frontal Sinusitis?

1. Nasal Congestion

Nasal congestion is one of the most common symptoms, typically presenting as persistent, unilateral nasal obstruction. It results primarily from acute mucosal hyperemia and swelling, along with accumulation of secretions in the nasal cavity. Nasal airflow may temporarily improve after clearing secretions, but congestion recurs shortly thereafter. Additionally, olfactory dysfunction—usually transient—may occur; however, if untreated, it may become permanent. This is commonly due to mucosal swelling and hypertrophy obstructing the olfactory cleft or impairment of olfactory nerve function.

2. Rhinorrhea

Rhinorrhea is another prominent symptom, often characterized by copious mucopurulent or purulent nasal discharge that is difficult to clear completely. Purulent discharge may contain small amounts of blood. Discharge tends to be more pronounced in the morning, often related to gravitational drainage influenced by head position. Postnasal drip may occur, with purulent secretions draining into the nasopharynx and oropharynx, irritating the mucosa and causing pruritus, nausea, coughing, and expectoration. In cases complicated by frontal bone osteomyelitis, a purulent fistula may develop over the frontal region—most commonly located on the anterior wall or floor of the frontal sinus.

3. Headache

Headache commonly occurs when frontal sinus drainage is obstructed, often manifesting as referred pain within the trigeminal nerve distribution. Initially, headache may be generalized, but it gradually localizes to the superior medial orbital angle and frontal region on the affected side. Headache follows a distinct temporal pattern: it begins upon waking, progressively intensifies throughout the morning, and starts to subside by early afternoon, disappearing entirely by evening—only to recur the following day. Smoking, alcohol consumption, and emotional stress may exacerbate headache severity.

4. Systemic Symptoms

Systemic manifestations commonly include anorexia, irritability, chills, fever, constipation, insomnia, and lethargy. Additional symptoms may include hoarseness, impaired memory, and difficulty concentrating. When acute frontal sinusitis develops secondarily to acute rhinitis or other acute infectious diseases, these systemic symptoms may reflect worsening of the underlying condition.

The above outlines the characteristic symptoms of frontal sinusitis. We hope this information is helpful to you.