PMC6159235_01
Preoperative photo demonstrating severe swelling of the left side of the face.
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The swelling was warm, red and had several non-ruptured pus-filled foci (Figure 1).
Preoperative venous phase contrast-enhanced CT images showing left side soft tissue enlargement of the face and neck with abscess cavities in (a) coronal reformat and (b) axial reformat.
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CT imaging, which was performed using a dual-source 128-multiple detector CT scanner (Somatom Definition Flash, Siemens Healthcare). CT imaging demonstrated a transspatial, multilocular abscess with extension from the zygomatic arch to the level of C4/C5 and posterior from the sternocleidomastoid muscle along the base of the left mandible to the midline involving the buccinator space, the masticator space, the submandibular space, the lateral pharyngeal space and the retropharyngeal space (Figure 2a,b).
Preoperative 3D-CT volume-rendered reconstructed images demonstrating osteomyelitis and a pathological fracture of the mandibular condyle, which is marked with arrows.
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The extension of the infection both on the lateral and the medial aspects of the left condyle led to bone destruction and fracture with some displacement of the left mandibular condyle (Figure 3a,b).