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Clinical Problem Solving: Radiology
Oct 2011

Radiology Quiz Case 3

Arch Otolaryngol Head Neck Surg. 2011;137(10):1041. doi:10.1001/archoto.2011.167-a

A 30-year-old man presented with a long-standing history of bilateral, intermittent facial pain and swelling. He recalled multiple episodes of these symptoms occurring intermittently each year since he was 8 years old. The episodes included bilateral pain and swelling over the cheeks and preauricular areas that typically lasted for hours to days. In addition to the pain and swelling, he stated that during certain episodes he noticed an audible sound of “wind” when he massaged or pressed the area in front of his ear. The number of episodes had increased over the past year, and he had been seen by a primary care physician and an otolaryngologist for his symptoms. The findings of previous imaging had appeared normal according to the patient, and he had been treated with oral antibiotics during previous episodes. He had no history of trauma or dental problems. He had a 15 pack-year history of smoking and occasional alcohol use. He denied weight loss and chronic fevers and had received all childhood immunizations.