Patient History
Sinusitis.
Findings
There is diffuse opacification of the right nasal cavity extending superiorly to involve the right ethmoid air cells and extending posteriorly to involve the right sphenoethmoidal recess and extending into the right sphenoid sinus. There are multiple areas of increased attenuation within this abnormality. This is associated with expansion of the ethmoid sinuses with mild regressive remodeling of the posterior aspect of the right lamina papyracea and leftward deviation of the superior nasal septum. There is enlargement of the right sphenoethmoidal recess.
Hypoplastic right maxillary sinus with near complete opacification. Mild increased attenuation which could be due to superimposed fungal colonization. Mucosal thickening involving alveolar recess left maxillary sinus.
Imaging of the anterior skull base shows no evidence of aggressive lesions eroding the anterior skull base. No evidence of encephalocele. Cribriform plate is intact.
Visualized portion of the brain shows prominence of the sulci and ventricles. However, dedicated brain imaging is necessary for complete diagnostic evaluation.
Conclusions
1. Diffuse mucosal thickening associated with increased attenuation and regressive remodeling and expansion of the involved paranasal sinuses most consistent with allergic fungal sinusitis involving the nasal cavity, right ethmoid sinus and right sphenoid sinus.
2. Near complete opacification of a hypoplastic right maxillary sinus that is likely due to chronic polypoid mucosal thickening.
