J Korean Assoc Oral Maxillofac Surg.  2015 Feb;41(1):43-47. 10.5125/jkaoms.2015.41.1.43.

Cavernous sinus thrombosis progression from trismus

• Cho JY
• Kim HM
• Ryu JY

• KMID: 2328653
• DOI: http://doi.org/10.5125/jkaoms.2015.41.1.43

Abstract

In the Department of Oral and Maxillofacial Surgery, patients with trismus can be easily identified. If the cause of trismus is infection of the masticatory space near the pterygoid plexus, the possibility of cavernous sinus thrombosis should be considered. We report the case of a patient who presented with limited mouth opening and progressed to cavernous sinus thrombosis, along with a review of the relevant literature.

Keyword

Cavernous sinus thrombosis; Trismus; Dental focal infection

MeSH Terms

Cavernous Sinus Thrombosis*
Focal Infection, Dental
Humans
Mouth
Surgery, Oral
Trismus*

Figure

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  Fig. 1 Transcranial view indicates limitation of mouth opening. A. Right temporomandibular joint (TMJ): close. B. Right TMJ: open. C. Left TMJ: open. D. Left TMJ: close.

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  Fig. 2 Orthopantogram view indicates chronic periodontitis of the right maxillary posterior teeth.

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  Fig. 3 Clinical view of right proptosis. Written informed consent has been obtained to publish clinical photographs.

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  Fig. 4 Transfemoral carotid angiography of the right internal carotid artery (RICA). A. Anteroposterior view. B. Lateral view.

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  Fig. 5 A. Magnetic resonance imaging (MRI) demonstrates engorgement of the right superior ophthalmic vein (arrow). B. Computed tomography illustrates enhancement of the retrobulbar tissues (white arrow) and dilation of the right cavernous sinus (black arrow). C. MRI shows swelling of the lateral pterygoid muscle with pus formation.

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  Fig. 6 Preoperative computed tomography depicts mucosal thickening of the right ethmoidal and maxillary sinus.

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  Fig. 7 A. Postoperative computed tomography (CT) shows improvement in the engorgement of the right superior ophthalmic vein. B. Postoperative CT demonstrates improvement in the dilation of the right cavernous sinus.

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  Fig. 8 Postoperative clinical view shows complete resolution of orbital symptoms. Written informed consent has been obtained to publish clinical photographs.

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