All sequelae of acute sinusitis are rare except for relapse or recurrence. Local complications of sinusitis include osteomyelitis and mucocoele. The most feared sequela is extension into bone and/or the central nervous system. Extension into the orbit or the cavernous sinus is extremely rare. Extension of frontal sinusitis anteriorly into the frontal bone can cause a distinct swelling (Pott's puffy tumor). Thus, frontal headache, fever, and swelling over the forehead should always suggest a complication of sinusitis. This is especially true in adolescent and young men. Osteomyelitis, if present, requires prolonged antibiotics as well as removal of necrotic bone.
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