Orbital complications following extraction of mandibular mol
This case, published in the journal Oral Surgery illustrates a rare, but potentially extremely serious, complication of infection following the extraction of mandibular teeth. Infection involving the orbit is not commonly linked to extraction of lower teeth, but surgeons should be aware that it could occur.

A 29‐year‐old male presented with progressive right‐sided circumorbital cellulitis on a background of right periorbital, temporal, and preauricular cellulitis. A baseline CT scan of the face had been undertaken, showing an orbital collection, requiring urgent treatment by the ophthalmic surgical team.

Due to the initial lack of Oral and Maxillofacial Surgery input, the mandible was omitted from the original scan and did not include the inferior border of the collection.

There was ophthalmoplegia on the affected side, but his visual Although there was gas collection indicated on CBCT and there was oedema and erythema over the right zygomatic region, there was no sign of skin necrosis.

The ophthalmology team drained pus from the orbit by opening the lateral canthus, lateral rim, orbital floor, and eyelid. An abscess cavity was found along the inferolateral orbit from where pus was also drained. A drain was inserted at the lateral canthus. The lateral canthus was reformed at the time of surgery. The CBCT findings were enough for the ophthalmology team to go to theatre with ENT input without considering the patient's recent history of dental extractions.

Only during the procedure, it was noted that the patient had recently (within the last 3 days) undergone surgical removal of the lower right 8, 7 and 6. The Oral and Maxillofacial Team were, therefore, called. A buccal sulcus incision to the upper right quadrant resulted in the drainage of copious pus on sub periosteal blunt dissection. Further significant amounts of pus were drained from the submasseteric space. Drains were placed in the buccal and submasseteric spaces.

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