case_images: PMC10938594_01
case_images: Left periorbital swelling with left facial swelling and proptosis.
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case_images: F1
case_images: Her fourth admission was at the age of 3 and a half months with poor feeding, irritability, severe nasal congestion, left-sided facial swelling, redness with periorbital edema, and proptosis (Figure 1) consistent with a diagnosis of left orbital cellulitis.
case_images: Gush of pus from left maxillary sinus upon initial cannulation.
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case_images: PMC10938594_01_fped-12-1340367-g002.jpg
case_images: F2
case_images: Uncinectomy, anterior ethmoidectomy, and maxillary mega antrostomy with partial inferior turbinectomy were performed (Figure 2).
case_images: Eroded left posterior maxillary wall with exposure of pterygopalatine fossa content.
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case_images: F3
case_images: The posterior wall of the maxillary sinus was eroded with exposure of the contents of the pterygopalatine fossa (Figure 3).
case_images: Second look intra oral left hard palate involvement.
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case_images: F4
case_images: In addition, there was erosion of the bone secondary to extensive inflammation in the hard palate (Figure 4).
case_images: Axial CT scan of the paranasal sinuses shows a destructive inflammatory process of the left pterygopalatine fossa and widening of the foramen.
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case_images: PMC10938594_01_fped-12-1340367-g005.jpg
case_images: F5
case_images: Urgent head and neck CT with contrast revealed extensive progression of the pterygopalatine fossa abscess and thromboses of the left cavernous sinus, external and internal jugular veins (Figure 5).
case_images: Coronal MRI of the paranasal sinuses shows an inflammatory process involving the left maxillary sinus, ethmoid sinus, floor of the orbit, and inferiorly into the sections of the hard palate.
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case_images: F6
case_images: She was urgently taken to the operating room for source control including drainage of a hard palate collection that was bulging into the nasal floor (Figure 6).