Introduction:

Frontal sinusitis is a rare but potentially serious infection that can lead to intracranial complications such as brain abscesses. Herein, we present a case of a brain abscess secondary to frontal sinusitis with a posterior table defect, treated using a combined surgical approach.

Case:

A 59-year-old man presented with seizures and loss of consciousness one month after being diagnosed with acute sinusitis and preseptal cellulitis. Computed tomography (CT) revealed a brain abscess in the patient’s frontal lobe. Following surgical drainage, an 11 mm defect was identified in the posterior table of the frontal sinus, which was repaired through an additional surgical intervention. Endoscopic sinus surgery was performed to remove the pathological tissue, followed by an external osteoplastic approach with fibrin glue and hemostatic agents, and placement of an otologic ventilation T-tube in the frontal sinus ostium.

Conclusion:

Intracranial complications of frontal sinusitis can be successfully managed using a multidisciplinary approach and appropriate surgical techniques. Early diagnosis, treatment timing, surgical planning, and maintenance of frontal sinus drainage in complicated frontal sinusitis are critical.