What should you know about frontal sinus osteomyelitis?

The frontal sinuses are air spaces behind the forehead. Infection in the sinus can extend into nearby bone, although forehead pain or sinus pressure alone does not establish bone infection. A person may develop fever, persistent headache, forehead tenderness or swelling, nasal discharge, or pain that continues despite usual sinus care. The condition can involve tissues near the eyes or the coverings around the brain, which is why clinicians take it seriously.

Evaluation may include an examination of the nose, face, eyes, and nervous system, plus imaging to view the sinus and surrounding bone. Blood tests and, in selected cases, a sample can help guide treatment. Symptoms may change, so report deterioration even if a previous visit was reassuring.

Contact a doctor promptly when sinus symptoms are severe, persistent, or accompanied by forehead swelling or fever. Take only medicines recommended for you; do not use leftover antibiotics. The treating team may involve an ear, nose and throat specialist and an infectious-disease clinician. Treatment can include antimicrobial medicine, drainage of infected material, or surgery when bone or blocked sinus tissue needs attention.

Keep follow-up appointments and ask how improvement will be checked. If a procedure leaves a bone defect, reconstruction may be discussed; [Bone Grafting](/treatments/trauma-and-fracture-care/bone-grafting/) is one treatment topic your team may explain when relevant.

Go to emergency care for swelling around the eye, double vision, reduced vision, confusion, a stiff neck, seizure, severe worsening headache, repeated vomiting, weakness, or marked drowsiness. These symptoms may signal spread beyond the sinus and cannot safely be assessed by home observation. Fever with rapidly increasing forehead swelling also needs urgent review.

Ask whether the infection involves the sinus lining, bone, or nearby tissues; which scan is appropriate; whether drainage or a sample is needed; and how treatment response will be monitored. Clarify which nasal, eye, neurological, or fever symptoms should prompt an immediate return.