A CASE OF 61/FEMALE CT MAXILLO-FACIAL STUDY (Abscess, Left Zygomatic Area. Left Eye/Chin Swelling)
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CLINICAL INFORMATION: Left side face - maxillozygomatic area mass. For CT evaluation.
TECHNIQUE: Multislice (128MDCT) axial sections of the MAXILLO-FACIAL without contrast with coronal - sagittal reformations.
There is a large, lobulated expansile soft tissue attenuation mass involving the left maxillary sinus. It measures around 5.8
x 6 x 7 cm and is expansile with destruction of the sinus walls bulging anterolaterally with involvement of the zygomatic
region, medially into the left side nasal cavity abutting the nasal septum and bowing it to the right. There is destruction of
the left side nasal bone with mass effect displacing the nose to the right side. Mass extension inferiorly eroding the left
side hard palate and extending into the left side soft palate. Mass extending to the left orbit with erosion of the orbital
floor and the medial wall with soft tissue mass extending to the orbital cavity involving the left inferior rectus muscle and
portion of the left medial rectus muscle. There is mass effect with outward displacement of the left globe as well as
superior displacement with globe abutting the orbital roof. There is superior displacement of the left optic nerve. Soft
tissue opacification of the left ethmoid sinus as part of tumor infiltration. Destruction of the left side posterolateral wall of
the sinus with tumor infiltration into the left masticator space.
There is obliteration of the left ostiomeatal complex. Mucosal density seen in the left sphenoid sinus.
The frontal sinuses are not developed.
The right maxillary sinus is developed and aerated. Mucosal density seen in the antrum. Sinus walls are intact.
The right maxillary sinus ostium is patent. No mass is seen in the right nasal cavity.
The right ostiomeatal complex is patent.
Aerated right middle meatus consistent with concha bullosa.
The right ethmoid sinus is aerated and clear.
The right sphenoid sinus is clear. Sinus walls are intact.
The right orbit is intact with intact sinus walls. The right globe and intraorbital soft tissue structures are intact.
Both mastoids are well developed and aerated and clear. No bone erosion is seen.
- Large, lobulated expansile soft tissue mass centered in the left maxillary sinus with bone erosion and infiltration of the
adjacent soft tissue structures, left orbit and left nasal cavity, and resultant mass effect as detailed above. Correlate with
Obstructed left ostiomeatal sinus
Right maxillary sinus and left sphenoid sinus disease.
Tumor infiltration of the left ethmoid sinus
Patent right ostiomeatal complex with right concha bullosa