PMC7533631_01
CT scan on day 1, coronal view. Note the right-sided maxillary and ethmoidal sinusitis and apical translucency surrounding the first upper molar (orange arrow). The medial surface of the right orbit appears clouded, suggesting intraorbital infection spread (red arrow).
gr1.jpg
PMC7533631_01_gr1.jpg
fig0005
Contrast enhanced CT (Fig. 1) showed right-sided pansinusitis of odontogenic origin and associated intraorbital fluid collection with air trapping, suggestive of a subperiosteal abscess.
Intraoral view 1 day following extraction of the first upper molar. A rubber drain is fixed in the newly created oroanthral communication.
gr2.jpg
PMC7533631_01_gr2.jpg
fig0010
A rubber drain was sutured into the communication to enable drainage of pus (Fig. 2).
CT scan of the orbital abscess on day 3, showing compression of the medial rectus muscle. Proptosis is present.
gr3.jpg
PMC7533631_01_gr3.jpg
fig0015
A new CT scan showed expansion of the subperiosteal abscess, with compression of the medial rectus muscle and obliteration of the orbital adipose tissue surrounding the optic nerve (Fig. 3).
Surgical exploration of the orbital abscess on day 3 through incisions made in the upper and lower eyelids. For each incision, a drain was left in place.
gr4.jpg
PMC7533631_01_gr4.jpg
fig0020
After thorough rinsing, two drains were left in place (Fig. 4).