OtoRhinoLaryngology Portal

The Leading Online Gallery of Otolaryngology and Head & Neck Surgery Specialty

OtoRhinoLaryngology Portal Video Collections @

YouTube & MEDtube

Sinus Disease

Acute Rhinosinusitis with Discharging Mucopus

Acute rhinusitis presents with fever, facial pain and headache usually following viral infection.  Nasal examination reveals congested turbinates, oedematous mucosa, and discharging mucopus around middle turbinate or in postnasal space.


Watch video of draining mucopus from middle meatus @ YouTube

 Watch video of draining mucopus from sphenoethmoid recess @ YouTube

Watch video of endoscopic-assisted antral washout @ YouTube



Coakley antrum trocar commonly used to perform antral puncture and the subsequent washouts.  

Sphenoid Sinusitis: Mucopus Drainage

Isolated left-sided sphenoid sinusitis presenting as severe central and occipital headache in a 16 weeks pregnant patient.  Endoscopy revealed thick mucopus draining along left sphenoethmoid recess ( dotted line) resulting in postnasal drip.  [A - remnant of adenoids, V - vomerine part of nasal septum, IT - tail of inferior turbinate].

Similar mucopurulent postnasal drip in another patient as seen from right nasal cavity.  (IT - tail of inferior turbinate, V - vomer)

 Copious mucopus postnasal drip.  (arrow - Eustachian tube opening}

Postnasal Drip


Turbid tenacious mucous.

Frank mucopus postnasal drip in bilateral pansinusitis

as seen by using transoral nasopharyngoscopy technique.


Watch video of tracking mucopus trail towards its source @ YouTube


Acute Sinusitis: Antral Washout

 Paranasal sinus X-ray in Caldwell's view showing bilateral air-fluid level in maxillary sinuses.



 Coakley trocar in-situ soon after punctured into medial wall of maxillary sinus.



Thick green mucopus seen exited left middle meatus upon washout. 


Postnasal Reactive Lymphoid Hyperplasia in Prolonged Postnasal Drip