Abcès de la face révélant une sinusite maxillaire d'origine dentaire

Maxillary sinusitis is exceptionally externalized. We report an unusual case of maxillary sinusitis externalized through the average meatus by following the intersinusonasal bulkhead toward the anterior angle of the maxilla and the nasogenian sulcus. The study involved a patient aged 17 years, with no previous medical history, presenting with facial swelling associated with right nasal obstruction occurred two days before. Clinical examination revealed febrile patient with abscess in the right nasogenian sulcus (A), with total filling of the right nasal fossa by a renitent submucosal bulge. Contrast-enhanced CT scan of the facial bones showed right maxillary sinusitis enlarging the average meatus (B) with collections in the intersinusonasal bulkhead and in the nasogenian sulcus. Furthermore, it showed intrasinusal migration of the 17th tooth root (C). The diagnosis of maxillary sinusitis of dental origin exteriorized to the face was made. Under general anesthesia, drainage of the different purulent collections through an incision in the nasal vestibule, middle meatotomy for drainage of the maxillary sinus and extraction of the 17(th) tooth were performed. Patient's evolution was favorable with regression of fever and of inflammatory signs.