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Can impact from a mild TBI injury lead to frontal sinus?

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Posted on Fri, 12 Oct 2018
Question: HI,

I suffered a mild TBI years ago from a blunt force injury to the left frontal sinus area with a golf ball going over 100mph. Right after the impact my nose was excessively bleeding even though I was not hit in the nose at all. A ct scan the next day showed mucosal thickening in the frontal sinus area with extensive sinusitis. It was so pronounced they transported me by ambulance to the hospital because they were worried it could be CSF rhinnorea. Since then, I have suffered with chronic sinusitis and post-concussive headaches.

Just recently I had to get sinus surgery, it was very extensive including septoplasty, turbine cleaning, and frontal sinus drilling. My left frontal sinus was so closed off they could not get into it, hence the drilling. My ENT told me I am now at risk for stenosis in my frontal sinuses and I may need additional surgeries if I suffer from additional frontal sinus issues. I have already gotten a sinus infection 3 weeks after surgery and the headaches are much worse now.

My question is this....Is there a possibility the impact from the mild TBI injury could have damaged the frontal sinus in any way? The imaging did not show any fracture but I have heard some hairline fractures don't always show up. Additionally, the excessive sinusitis and frontal congestion in the imaging, could that have been blood from the actual injury since I suffered a massive nose bleed from an injury not near the nose? I wonder if the impact from the injury has contributed to these sinus problems....

Thank you for your time.

doctor
Answered by Dr. Chobufo Ditah (2 hours later)
Brief Answer:

Findings of sinusitis at that time cannot be attributed to the trauma.

Detailed Answer:

Hi,

Blood in sinus is very distinct from signs of chronic sinusitis.

This might have been coincidental to have been identified during this extensive workup.

No radiologist would confound a blood clot in a sinus for sinusitis.

However, it would be extremely difficult to completely rule out any possible aggravation from the golf ball.

Unfortunately, it is a hard case to make and there is little evidence to suggest that.

With no bone fracture, no accumulated blood in sinuses, etc., it is impossible to build a case around this.

On another note, did you ever have any sinus related problems before this incident?

Hope I have answered your query.

Take care

Regards,
Dr Chobufo Ditah, General & Family Physician
Above answer was peer-reviewed by : Dr. Yogesh D
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Dr. Chobufo Ditah

General & Family Physician

Practicing since :2009

Answered : 6318 Questions

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Can impact from a mild TBI injury lead to frontal sinus?

Brief Answer: Findings of sinusitis at that time cannot be attributed to the trauma. Detailed Answer: Hi, Blood in sinus is very distinct from signs of chronic sinusitis. This might have been coincidental to have been identified during this extensive workup. No radiologist would confound a blood clot in a sinus for sinusitis. However, it would be extremely difficult to completely rule out any possible aggravation from the golf ball. Unfortunately, it is a hard case to make and there is little evidence to suggest that. With no bone fracture, no accumulated blood in sinuses, etc., it is impossible to build a case around this. On another note, did you ever have any sinus related problems before this incident? Hope I have answered your query. Take care Regards, Dr Chobufo Ditah, General & Family Physician