Case 43 - Allergic Fungal Sinusitis with Mucocele

Dr. Yousem has provided the following report as a sample report for your reference. It does not match the case reviewed in the video.

Indication: Chronic sinusitis possible surgery

TECHNIQUE: Axial CT scan images were performed through the paranasal sinuses with coronal and sagittal reconstructions of the axial CT data.

FINDINGS:

There is expansion of the right frontal sinus with dehiscence of the bone posterior laterally such that it communicates with the frontal lobe. This area measures approximately 3.1 cm x 5 cm and has areas of mixed density secretions. There also appears to be communication with the superior medial orbit on the right side. There is opacification of the ethmoid sinuses bilaterally. There is polypoid change in the sphenoid sinus as well as in the sinonasal cavities on the right side greater than left.

The patient has undergone bilateral medial antrostomies. Partial ethmoidectomy on the left side is evident.

On the coronal views there is downward displacement of the roof of the right orbit with areas of dehiscence in the bone from the right frontal sinus mucocele.

The hyperdense secretions extend from the right frontal sinus to the right ethmoid sinus to the level of the right middle turbinate and nasal cavity. There is also hyperdense opacification of the right maxillary antrum.

The visualized portions of the brain show no definite abnormalities despite the communication with the right frontal sinus mucocele.

There is thinning of the bone of the cribriform plate without gross dehiscence bilaterally.

There appears to be very slight proptosis of the right globe compared with the left possibly from the pressure from above.

IMPRESSION:

Right frontal ethmoidal mucocele with communication with the intracranial compartment of the right frontal lobe anterior cranial fossa and with communication with the right orbital roof.

Chronic sinonasal polyposis and sinusitis with inspissated secretions worse on the right side than the left side.

Bilateral medial antrostomies and ethmoidectomies with areas of thickened bone in the cribriform plate bilaterally.