Intracranial and intraorbital complications of paranasal sinusitis constitute true surgical and medical emergencies. Owing to the availability of improved antibiotics, however, oral surgeons seldom encounter severe infections leading to death. We present a severe case of cavernous sinus syndrome associated with intraorbital cellulitis, intraorbital abscess, and cavernous sinus thrombosis primarily due to odontogenic sinusitis. This syndrome was considered to have a mortality rate of 100% before the development of improved antibiotics. Even now, the mortality rate is 13.6%, and the rate of sight loss is 22.7%. That patient was a 29-year-old man with multiple caries. We drained the maxillary sinus and intravenously administered antibiotics with gamma globulins. We were fortunately able to save his life without compromising the patient's quality of life, by collaborating with neurosurgeons, ophthalmologists, and otolaryngologists.
