A 14-YEAR-OLD GIRL PRESENTED TO THE emergency department with an 8-day history of worsening headache and rightsided nasal obstruction. She complained of pain and pressure localized primarily over the right periorbital and temporal region. She reported mild puffiness in the region and associated nausea but denied blurry or double vision, fevers, chills, or epistaxis. Her medical history was significant for type 1 diabetes mellitus, attention-deficit/hyperactivity disorder, and migraine headaches, which are characterized by nonfocal pain lasting no more than 2 days. Nasal endoscopy revealed a pinkish white mass at the right middle meatus ostium with underlying purulence. The mass obstructed the entire right nasal cavity except for a sliver of space inferiorly. The left nasal cavity was patent but narrowed from septal deviation.A noncontrast sinus computed tomographic (CT) scan (Figure 1) demonstrated an expansile lesion of JAMA OTOLARYNGOL HEAD NECK SURG/ VOL 139 (NO. 4), APR 2013 WWW.JAMAOTO.COM 421