Clinical Photo of The Week: Vol1, No2

This case was presented in the recent edition (Vol1N02) of otolaryngology newsletter:
48-year old male with 3-year history of "something salty/sour trickling down the cheek into the mouth on the right side". Has long-standing history of 'sinusitis'. Had history of a couple of dental extractions. O/E findings include slightly swollen and tender anterior cheek on the right, and the sign displayed in this picture. Sinus x-ray showed opacity of right maxillary sinus. Proof right maxillary antral aspiration yielded 40 mls of frank pus. On antral lavage, effluent noted from this point .
Diagnosis: Anaerobic osteomyelitis complicating chronic infective right maxillary sinusistis. For anaerobic osteomyelitis, see this Medline Abstract