A healthy, normal-appearing 4-month-old white boy presented with a 2-month history of significant nasal congestion that interfered with feeding and caused obstructive breathing during sleep. A computed tomographic (CT) scan of his paranasal sinuses revealed bilateral maxillary opacification and medial bulging of the lateral nasal walls (Figure 1). An ophthalmologic evaluation ruled out any abnormalities of the nasal lacrimal duct apparatus. Administration of topical nasal saline, steroid sprays, a proton pump inhibitor, and antibiotics did not improve the patient's symptoms. He was subsequently taken to the operating room for bilateral maxillary antrostomies (Figure 2 and Figure 3).
Bakthavachalam S, McClay J. Radiology Quiz Case 1. Arch Otolaryngol Head Neck Surg. 2007;133(1):90. doi:10.1001/archotol.133.1.90