PMC7989944_01
Timeline. This timeline shows the patient's symptoms, imaging studies, and treatment.
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F1
Otolaryngological examinations were unremarkable, except for percussion pain from the upper right central incisor to the first molar and gingival sensory disturbance in those regions (Fig. 1).
Axial T2-weighted head MR image on the day following initial onset. This MR image reveals acute sphenoid sinusitis, including fluid (arrowheads).
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F2
The patient was examined using head magnetic resonance imaging (MRI), which detected inflammatory findings in the right ethmoid sinus and slight fluid retention in the right sphenoid sinus (Fig. 2).
Axial T2-weighted follow-up MR image 1 month after onset. This MR image reveals chronic sinusitis of the right greater wing, which is filled with mucosa and fluid (arrowheads), and the ethmoid sinus, which has thick mucosa (arrows).
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F3
Because her symptoms persisted, the patient revisited the neurologist 1 month after the onset, and an additional MRI scan revealed chronic sinusitis in the right sphenoid sinus (Fig. 3).
Coronal cross-sectional CT images 7 weeks after onset. These coronal sinus CT images line the dorsal to the ventral side toward the bottom. They reveal a bone defect around the maxillary nerve facing the sphenoid sinus (arrowhead) as well as sphenoid sinusitis with fluid retention (asterisk).
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F4
And the coronal thin-sliced bone CT revealed the absence of the bony boundary between the sizeable sphenoid sinus and maxillary nerve (Fig. 4).