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Initial CT before the first surgical intervention at the regional secondary otorhinolaryngology service showed sphenoid sinus opacification and the involvement of different adjacent structures

(A) axial CT shows the dehiscent lateral wall of the right sphenoid sinus (SS) and medial orbital apex (OA); (B) axial CT shows widened right Vidian canal (*), pterygopalatine fossa (**), and mucosal fossa (**) and mucosal thickening in the lateral recess (LR) of the sphenoid sinus; (C) sagittal CT shows eroded superior part of the right Vidian canal and mucosal thickening of the lateral recess of the sphenoid sinus; (D) coronal CT shows mucosal thickening in the right posterior ethmoid sinus and dehiscence of the medial orbital wall.

(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.)