History of odontogenic abscesses, osteomyelitis: persistent facial swelling. The images are degraded by patient motion. There has been interval removal of packing material from the left upper neck wound. There is interval decrease in size of the masticator space fluid collections, with a residual collection that measures 12 x 16 x 50 mm within the anterior belly of the left temporalis muscle, surrounding the coronoid process. There is a background of residual extensive diffuse edema mainly in the lateral masticator space soft tissues. There is also signal abnormality in the left mandibular ramus. In addition, there are mild inflammatory changes in the anterior left parotid gland. There is left otomastoid fluid, likely due to Eustachian tube dysfunction. There is extensive mucosal thickening within the maxillary and ethmoid sinuses.
Involution of the extensive left masticator space infectious process with decrease in size of the left temporal fossa fluid collection that likely represents an abscess involving the anterior belly of the temporalis muscle, and persistent myositis, cellulitis, and left mandibular osteomyelitis, as well as probable partial left parotitis. Assessment is otherwise limited by the lack of intravenous contrast and excessive patient motion. Furthermore, a CT may be useful to further assess the dentition.