PMC7154271_01
a-c Preoperative photograph of the face. a Frontal view. b Right eye (mirror-reversed image). c Left eye. d-f Intraoperative findings. d Horizontal skin incision. e The skin is pressed by the fingers. f A large amount of pus drains out. g, h Photographs of the face on the 1st (g) and 20th (h) postoperative days. The left palpebral swelling has improved significantly.
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F1
A 45-year-old man who complained of a 1-week history of swelling, erythema, and pain around his left upper eyelid (Fig. 1a-c) was referred to our hospital. Therefore, the skin of the left upper eyelid was successfully incised under local anesthesia, and a large amount of pus and blood was excreted (Fig. 1d-f). Postoperatively, there was significant improvement in the left upper eyelid (Fig. 1g, h).
a-d Initial orbital MRI. a, b Fat-suppressed T2-weighted coronal image. a Sinusitis centering on the left frontal and maxillary sinuses (arrowheads). b Left frontal sinusitis connected to the palpebral abscess (arrowheads). c Fat-suppressed T2-weighted axial image shows left palpebral cellulitis (arrowheads). d T2-weighted axial image shows left palpebral abscess (arrowheads). e-g Orbital CT scan after the eyelid operation. e Axial image shows osteomyelitis of the left frontal sinus anterior, inferior, and posterior walls (arrowheads). Coronal image (f) and sagittal image (g) show bone destruction of the left frontal sinus inferior wall (arrowheads).
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F2
The patient was already subjected to orbital MRI at the local hospital, which showed left upper palpebral cellulitis, sinusitis in the left frontal and ethmoid sinuses, and no intracranial complications (Fig. 2a-d). CT examination on the operation day showed left frontal sinus osteomyelitis and osteolysis of the inferior wall of the left frontal sinus connected to the left upper eyelid (Fig. 2e-g).