Editing Sinusitis (section)

=== Complications ===
{| class="wikitable" style="float: right; margin-left:15px; text-align:center"
|+Chandler Classification
|-
!scope="col"| Stage
!scope="col"| Description
|-
!scope="row" style="text-align:left; font-weight:normal;"| I
| Preseptal cellulitis
|-
!scope="row" style="text-align:left; font-weight:normal;"| II
| Orbital cellulitis
|-
!scope="row" style="text-align:left; font-weight:normal;"| III
| Subperiosteal abscess
|-
!scope="row" style="text-align:left; font-weight:normal;"| IV
| Orbital abscess
|-
!scope="row" style="text-align:left; font-weight:normal;"| V
| Cavernous sinus septic thrombosis
|}
Complications are thought to be rare (1 case per 10,000).<ref name="pmid18206715"/> Infectious complications of acute bacterial sinusitis include [[Orbit (anatomy)|eye]], [[Cranial cavity|brain]] and [[Osseous|bone]] complications.<ref name=":0">{{Cite book |last1=Scholes |first1=Melissa A. |title=ENT secrets |last2=Ramakrishnan |first2=Vijay R. |date=May 9, 2022 |publisher=Elsevier Health Sciences |isbn=9780323733588 |edition=5th |pages=155–160}}</ref>

==== Orbital complications ====
The Chandler Classification is used to group orbital complications into five stages according to their severity.<ref>{{cite journal|vauthors=Chandler JR, Langenbrunner DJ, Stevens ER|date=September 1970|title=The pathogenesis of orbital complications in acute sinusitis|journal=The Laryngoscope|volume=80|issue=9|pages=1414–28|doi=10.1288/00005537-197009000-00007|pmid=5470225|s2cid=32773653}}</ref> Stage I, known as preseptal cellulitis, occurs when an infection develops in front of the [[orbital septum]].<ref name=":1">{{Citation|last1=Bae|first1=Crystal|title=Periorbital Cellulitis|date=2024|work=StatPearls|url=https://www.ncbi.nlm.nih.gov/books/NBK470408/|access-date=2024-11-13|place=Treasure Island (FL)|publisher=StatPearls Publishing|pmid=29261970|last2=Bourget|first2=Daniele}}</ref> It is thought to result from restricted [[Venous|venous drainage]] from the sinuses and affects the soft tissue of the eyelids and other superficial structures.<ref name=":1"/> Stage II, known as orbital cellulitis, occurs when infection develops behind the orbital septum and affects the [[Orbit (anatomy)|orbits]].<ref name=":1"/> This can result in [[Ophthalmoparesis|impaired eye movement]], [[Exophthalmos|protrusion of the eye]], and [[Chemosis|eye swelling]].<ref name=":1"/> Stage III, known as subperiosteal abscess, occurs when [[pus]] collects between walls of the orbit and the surrounding periosteal structures.<ref name=":1"/> This can result in impaired eye movement and acuity.<ref name=":1"/> Stage IV, known as orbital abscess, occurs when an abscess forms within the orbital tissue.<ref name=":1"/> This can result in severe vision impairment.<ref name=":1"/> Stage V, known as cavernous sinus thrombosis, is considered an intracranial complication. It can occur as bacterial spread progresses, triggering blood clots that become trapped within the cavernous sinus.<ref>{{Citation|last1=Plewa|first1=Michael C.|title=Cavernous Sinus Thrombosis|date=2024 |work=StatPearls|url=https://pubmed.ncbi.nlm.nih.gov/28846357/|access-date=2024-11-13|place=Treasure Island (FL) |publisher=StatPearls Publishing|pmid=28846357|last2=Tadi|first2=Prasanna|last3=Gupta|first3=Mohit}}</ref> This can result in previously described symptoms within the opposite eye and in severe cases, meningitis.<ref name=":1"/>

==== Intracranial complications ====
The close proximity of the sinuses to the brain makes brain infections one of the most dangerous complication of acute bacterial sinusitis, especially when the frontal and sphenoid sinuses are involved. These infections can result from invasion of [[Anaerobic organisms|anaerobic bacteria]] through the bones or blood vessels. [[Abscesses]], [[meningitis]], and other life-threatening conditions may occur. In rare cases, mild personality changes, headache, altered consciousness, visual problems, seizures, [[coma]], and even death may occur.<ref name="Patient Education2">{{cite web |title=Sinusitus Complications |url=http://www.umm.edu/patiented/articles/what_symptoms_of_sinusitis_000062_4.htm |url-status=live |archive-url=https://web.archive.org/web/20100222004055/http://www.umm.edu/patiented/articles/what_symptoms_of_sinusitis_000062_4.htm |archive-date=2010-02-22 |work=Patient Education |publisher=University of Maryland}}</ref>

==== Osseous complications ====
A rare complication of acute sinusitis is a bone infection, known as [[osteomyelitis]], which affects the [[Frontal bone|frontal]] and other [[Facial skeleton|facial bones]].<ref name=":02">{{Cite journal |last1=Wadhwa |first1=Smriti |last2=Jain |first2=Shraddha |last3=Gupta |first3=Jaya |last4=Dobariya |first4=Harshil |last5=Pantbalekundri |first5=Nikhil |last6=Wadhwa |first6=Smriti |last7=Jain |first7=Shraddha |last8=Gupta |first8=Jaya |last9=Dobariya |first9=Harshil |last10=Pantbalekundri |first10=Nikhil |date=2024-02-13 |title=Osteomyelitis of Frontal Sinus: A Rare Sequelae of Acute Bacterial Sinusitis Associated With Anatomical Variations in the Frontal Sinus Drainage Pathway |journal=Cureus |language=en |volume=16 |issue=2 |pages=e54158 |doi=10.7759/cureus.54158 |doi-access=free |issn=2168-8184 |pmc=10940872 |pmid=38496067}}</ref> Specifically, the combination of frontal sinusitis, osteomyelitis and subperiosteal abscess formation is referred to as [[Pott's puffy tumor]].<ref name="Patient Education3">{{cite web |title=Sinusitus Complications |url=http://www.umm.edu/patiented/articles/what_symptoms_of_sinusitis_000062_4.htm |url-status=live |archive-url=https://web.archive.org/web/20100222004055/http://www.umm.edu/patiented/articles/what_symptoms_of_sinusitis_000062_4.htm |archive-date=2010-02-22 |work=Patient Education |publisher=University of Maryland}}</ref><ref name=":02" />

'''Other complications'''

When an infection originating from a tooth or dental procedure affects the maxillary sinus it can lead to [[odontogenic sinusitis]] (ODS).<ref>{{cite journal |last1=Craig |first1=John R. |last2=Poetker |first2=David M. |last3=Aksoy |first3=Umut |last4=Allevi |first4=Fabiana |last5=Biglioli |first5=Federico |last6=Cha |first6=Bruce Y. |last7=Chiapasco |first7=Matteo |last8=Lechien |first8=Jerome R. |last9=Safadi |first9=Ahmad |last10=Simuntis |first10=Regimantas |last11=Tataryn |first11=Roderick |date=2021-02-14 |title=Diagnosing odontogenic sinusitis: An international multidisciplinary consensus statement |journal=International Forum of Allergy & Rhinology |language=en |volume=11 |issue=8 |pages=1235–1248 |doi=10.1002/alr.22777 |issn=2042-6976 |pmid=33583151 |doi-access=free |hdl-access=free |hdl=2027.42/168522}}</ref> Odontogenic sinusitis can often spread to nearby sinuses including the ethmoid, frontal, sphenoid sinuses, and the contralateral nasal cavity.<ref>{{cite journal |last1=Saibene |first1=Alberto Maria |last2=Pipolo |first2=Giorgia Carlotta |last3=Lozza |first3=Paolo |last4=Maccari |first4=Alberto |last5=Portaleone |first5=Sara Maria |last6=Scotti |first6=Alberto |last7=Borloni |first7=Roberto |last8=Messina |first8=Francesco |last9=Di Pasquale |first9=Daniele |last10=Felisati |first10=Giovanni |date=December 2014 |title=Redefining boundaries in odontogenic sinusitis: a retrospective evaluation of extramaxillary involvement in 315 patients: Odontogenic sinusitis extramaxillary involvement |url=http://doi.wiley.com/10.1002/alr.21400 |url-status=live |journal=International Forum of Allergy & Rhinology |language=en |volume=4 |issue=12 |pages=1020–1023 |doi=10.1002/alr.21400 |pmid=25196643 |s2cid=28835025 |archive-url=https://web.archive.org/web/20240225034048/https://onlinelibrary.wiley.com/doi/abs/10.1002/alr.21400 |archive-date=2024-02-25 |access-date=2021-03-27}}</ref> In rare instances, these infections may spread to the [[Orbit (anatomy)|orbit]], leading to orbital [[cellulitis]].