Early diagnosis is important, and this requires folow-up on clinical suspicion. A patient who is comatose or heavily sedated cannot complain of pain or pressure.
Diagnostic strategy:
(1) imaging studies of all paranasal sinuses
(2) aspiration of affected sinus showing neutrophils and bacterial or fungal pathogens
Management:
(1) remove nasopharyngeal tubing if possible
(2) decongestants
(3) antibiotics
(4) rarely surgical drainage
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