、。
With tears running down her cheeks, she shouted at him.
Literal
She [topic-は] cheeks [on-に] tears [object-を] flowing [while-ながら], him [toward-に向かって] shouted.
This sentence is dramatic and structurally rich. ~ながら chains two simultaneous actions by the same subject; に向かって ('facing toward, directed at') marks the target of the shouting with vivid directionality, more pointed than plain に. ほお and ほほ are alternate readings/spellings of the same word ('cheek'); both are valid. The whole frame stages a confrontation in motion — tears flowing, voice raised, target singled out — characteristic of dramatic narration in fiction or memoir.