Frontal sinus abscess and secondary orbital cellulitis.

Despite modern antibiotics, frontal sinus abscess (and secondary orbital cellulitis) remains relatively common and potentially life-threatening. The declining incidence of chronic middle ear disease in the UK has made it one of the commonest causes of intracranial abscess. The speed with which suppuration can penetrate the sinus walls remains poorly understood and a research challenge. Management is best supervised by an ENT surgeon because the key decision is the timing of sinus surgery. The ENT surgeon, nevertheless, must be alert to the indications for consultation with neurosurgical colleagues. This paper aims to give an illustrated account of the clinico-pathological features and current management.