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Transnasal endoscopic surgical treatment of invasive fungal rhinosinusitis causing right-sided orbital apex syndrome, Horner syndrome, and pterygopalatine fossa infection

(A) right sphenoid sinus (SS) after sphenoidotomy, with polypoid (P) mucosa on its lateral wall obstructing lateral recess of sphenoid sinus and microabscess (M) on the sphenoid sinus floor; (B) view after right-sided extended middle meatal antrostomy showing maxillary sinus (MS), sphenoethmoidectomy, and drainage of pus from the pterygopalatine fossa (PPF); (C) decompression and drainage of the orbital apex (OA); (D) right pterygopalatine fossa and orbital apex after the decompression and drainage.

(Source: Benites G, Urbančič J, Bardales C, Vozel D. Sinonasal orbital apex syndrome, Horner syndrome and pterygopalatine fossa infection: a case report and mini-review. Life (Basel) 2023;13(8):1658. Creative Commons Attribution 4.0 International [CC BY 4.0] license, creativecommons.org/licenses/by/4.0.)