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CT Facial phlegmon

Technique: IV contrast enhanced helical CT of the facial bones was performed from the mid calvarium through the angle of the mandible. Coronal and sagittal reformats were provided. Findings: There are small, lobular foci of decreased attenuation demonstrated within the musculature of the left depressor anguli oris, immediately anterolateral to the left inferior premolar teeth. There is soft tissue swelling seen in this area as well. No focal ring enhancement is identified. This region is relatively edentulous, though the patient is also missing multiple additional teeth. No pathologic lymphadenopathy is identified. Evaluated lymph nodes demonstrate normal morphology. There is no evidence of vascular thrombosis or aggressive appearing osseous erosion. In limited evaluation, the basilar brain parenchyma is unremarkable. The mastoid air cells are well aerated. There is minimal osseous productive change seen at the atlanoaxial articulation. IMPRESSION: Phlegmonous change of the inferior left anterolateral premolar soft tissues without focal enhancement to suggest abscess.