Imaging of Silastic Cheek Implant Penetration Into the Maxillary Sinus

Figure 1. Axial computed tomographic scan showing a full-width defect of the anterior maxillary sinus adjacent to the medial edge of the right cheek implant (arrow). There is no associated mucosal thickening or infection around the implant. Note the normal contralateral anterior maxillary sinus wall and overlying cheek implant (arrowhead).

Figure 2. Axial computed tomographic scan showing a fluid collection that displaces the left cheek implant from the underlying bone (arrow). The medial edge of the left cheek implant has penetrated the full width of the anterior wall of the maxilla and migrated slightly into the sinus. There is considerable left maxillary sinus mucosal thickening. The right cheek implant has also penetrated the anterior wall of the maxillary sinus. There is mild mucosal thickening within the right maxillary sinus but not adjacent to the implant.

Figure 3. Axial computed tomographic scan showing migration of the right cheek implant, which has created a wide defect in the anterior wall of the maxillary sinus (arrow). There is a mild degree of mucosal thickening surrounding the medial portion of the implant, and there is a small amount of fluid surrounding the right cheek implant within the subcutaneous tissues.

Figure 4. Axial fat-saturated postcontrast T1-weighted magnetic resonance images (MRIs) at 2 different levels (A and B). The MRIs show penetration of the left cheek implant into the maxillary antrum and into the left nasal cavity through the nasoantral wall (arrow). There is linear enhancement within the subcutaneous tissues surrounding the left cheek implant (arrowheads). The right cheek implant was unremarkable.