The history should examine recent prodromal events (e.g., insect bites, trauma), allergen exposure, chronic dental caries, painful mastication, previous treatments with radiation, or silicone injections. The presence of dental or cosmetic appliances, nasal discharge, or vision changes should be ascertained. Systemic signs of infection should be excluded, such as fever and vomiting. A thorough head and neck exam is required. Occult infection, with extension from other head and neck structures, should be excluded.
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