. There are extensive postoperative changes from prior mastoidectomy including removal of all the ossicles. There is fluid and air within a large surgical cavity. Surgical clips and fixation screw are noted at the tegmentum tympani. The few remaining mastoid air cells are opacified. There is significant bony thinning adjacent to the right sphenoid sinus, although the sphenoid sinus has normal signal characteristics and appears patent on prior MRI study. Within the middle ear cavity, there are postoperative changes with small pockets of air and soft tissue density. There are multiple areas of bony irregularity and lytic changes with thinning of the bone. This may represent postsurgical changes, or changes associated with episodes of prior infections. Osteomyelitis cannot entirely be excluded. The bony wall of the carotid canal is intact without lytic changes to suggest direct extension. There is air density immediately lateral to the carotid canal. The jugular fossa is intact. The temporomandibular joint is intact. The bony coverings of the cochlea, vestibule, and semicircular canals are intact. Again seen is an area of hypoattenuation within the inferior right temporal lobe which is better characterized on recent MRI study. The external auditory canal is clear. The tympanic membrane is faintly visualized. The scutum remains sharp. The tympanic cavity and mastoid air cells are clear. The ossicular chain and tegmen tympani are intact. The inner ear structures have a normal morphology. The bony coverings of the cochlea, vestibule, semicircular canals, and facial nerve canal are intact. The vestibular aqueduct is within normal limits in size. No abnormalities of the osseous internal auditory canal are demonstrated.
clinical findings_fin: {'extensive postoperative changes': {'clinical finding': 'extensive postoperative changes', 'existence': 'pos_dx', 'descriptive_term': 'extensive postoperative', 'observation': 'change', 'strength_term': 'extensive'}, 'all the ossicles': {'clinical finding': 'all the ossicles', 'existence': 'pos_dx', 'descriptive_term': 'all the', 'observation': 'ossicle', 'quantity_term': 'all'}}anatomical entity_fin: {'fluid': {}}clinical findings_fin: {'large surgical cavity': {'clinical finding': 'large surgical cavity', 'cf_snomed': {'cavity': 2483006}, 'existence': 'pos_dx', 'descriptive_term': 'large surgical', 'observation': 'cavity', 'strength_term': 'large'}}object_fin: ['surgical clips']clinical findings_fin: {'surgical clips': {'clinical finding': 'surgical clips', 'existence': 'pos_dx', 'descriptive_term': 'surgical', 'observation': 'clip'}, 'fixation screw': {'clinical finding': 'fixation screw', 'existence': 'pos_dx', 'descriptive_term': 'fixation', 'observation': 'screw'}}anatomical entity_fin: {'mastoid air cells': {}}clinical findings_fin: {'few remaining mastoid air cells': {'clinical finding': 'few remaining mastoid air cells', 'existence': 'pos_dx', 'descriptive_term': 'few remaining mastoid air', 'observation': 'cell', 'quantity_term': 'few'}}anatomical entity_fin: {'sphenoid sinus': {}}location descriptor_fin: ['adjacent', 'right']clinical findings_fin: {'significant bony thinning': {'clinical finding': 'significant bony thinning', 'existence': 'pos_dx', 'descriptive_term': 'significant bony', 'observation': 'thinning'}, 'patent': {'clinical finding': 'patent', 'existence': 'neg_dx', 'observation': 'patent'}}anatomical entity_fin: {'middle ear cavity': {}}imaging observation_fin: ['soft tissue density']clinical findings_fin: {'postoperative changes': {'clinical finding': 'postoperative changes', 'existence': 'pos_dx', 'descriptive_term': 'postoperative', 'observation': 'change'}, 'soft tissue density': {'clinical finding': 'soft tissue density', 'existence': 'pos_dx', 'descriptive_term': 'soft tissue', 'observation': 'density'}}clinical findings_fin: {'bony irregularity': {'clinical finding': 'bony irregularity', 'existence': 'pos_dx', 'descriptive_term': 'bony', 'observation': 'irregularity'}, 'lytic changes': {'clinical finding': 'lytic changes', 'existence': 'pos_dx', 'descriptive_term': 'lytic', 'observation': 'change'}, 'thinning': {'clinical finding': 'thinning', 'existence': 'pos_dx', 'observation': 'thinning'}}clinical findings_fin: {'postsurgical changes': {'clinical finding': 'postsurgical changes', 'existence': 'unc_dx', 'descriptive_term': 'postsurgical', 'observation': 'change'}, 'changes': {'clinical finding': 'changes', 'existence': 'unc_dx', 'observation': 'change'}, 'prior infections': {'clinical finding': 'prior infections', 'existence': 'unc_dx', 'descriptive_term': 'prior', 'observation': 'infection'}}clinical findings_fin: {'osteomyelitis': {'clinical finding': 'osteomyelitis', 'cf_snomed': {'osteomyelitis': 60168000}, 'existence': 'unc_dx', 'observation': 'osteomyelitis'}}anatomical entity_fin: {'wall': {}, 'carotid canal': {}}clinical findings_fin: {'intact': {'clinical finding': 'intact', 'existence': 'neg_dx', 'observation': 'intact'}, 'lytic changes': {'clinical finding': 'lytic changes', 'existence': 'neg_dx', 'descriptive_term': 'lytic', 'observation': 'change'}, 'direct extension': {'clinical finding': 'direct extension', 'existence': 'unc_dx', 'descriptive_term': 'direct', 'observation': 'extension'}}anatomical entity_fin: {'carotid canal': {}}location descriptor_fin: ['lateral']clinical findings_fin: {'air density': {'clinical finding': 'air density', 'existence': 'pos_dx', 'descriptive_term': 'air', 'observation': 'density'}}anatomical entity_fin: {'jugular fossa': {}}clinical findings_fin: {'intact': {'clinical finding': 'intact', 'existence': 'neg_dx', 'observation': 'intact'}}anatomical entity_fin: {'temporomandibular joint': {}}clinical findings_fin: {'intact': {'clinical finding': 'intact', 'existence': 'neg_dx', 'observation': 'intact'}}anatomical entity_fin: {'cochlea': {}, 'vestibule': {}, 'semicircular canals': {}}clinical findings_fin: {'intact': {'clinical finding': 'intact', 'existence': 'neg_dx', 'observation': 'intact'}}anatomical entity_fin: {'right temporal lobe': {'location descriptor': 'inferior'}}location descriptor_fin: ['inferior']clinical findings_fin: {'hypoattenuation': {'clinical finding': 'hypoattenuation', 'existence': 'pos_dx', 'observation': 'hypoattenuation'}}anatomical entity_fin: {'external auditory canal': {}}clinical findings_fin: {'clear': {'clinical finding': 'clear', 'existence': 'neg_dx', 'observation': 'clear'}}anatomical entity_fin: {'tympanic membrane': {}}clinical findings_fin: {'tympanic membrane is faintly visualized': {'clinical finding': 'tympanic membrane is faintly visualized'}}anatomical entity_fin: {'mastoid air cells': {}}clinical findings_fin: {'mastoid air cells': {'clinical finding': 'mastoid air cells', 'existence': 'pos_dx', 'descriptive_term': 'mastoid air', 'observation': 'cell'}, 'clear': {'clinical finding': 'clear', 'existence': 'neg_dx', 'observation': 'clear'}}anatomical entity_fin: {'tegmen tympani': {}}clinical findings_fin: {'intact': {'clinical finding': 'intact', 'existence': 'neg_dx', 'observation': 'intact'}}anatomical entity_fin: {'inner ear': {}}clinical findings_fin: {'inner ear structures have a normal morphology': {'clinical finding': 'inner ear structures have a normal morphology'}}anatomical entity_fin: {'cochlea': {}, 'vestibule': {}, 'semicircular canals': {}, 'facial nerve': {}}clinical findings_fin: {'intact': {'clinical finding': 'intact', 'existence': 'neg_dx', 'observation': 'intact'}}anatomical entity_fin: {'vestibular aqueduct': {}}clinical findings_fin: {'normal limits in size': {'clinical finding': 'normal limits in size'}}anatomical entity_fin: {'internal auditory canal': {}}clinical findings_fin: {'abnormalities': {'clinical finding': 'abnormalities', 'existence': 'neg_dx', 'observation': 'abnormality'}}
<s>[INST] Write the finding section for a radiology report based on the following information: clinical findings_fin: {'extensive postoperative changes': {'clinical finding': 'extensive postoperative changes', 'existence': 'pos_dx', 'descriptive_term': 'extensive postoperative', 'observation': 'change', 'strength_term': 'extensive'}, 'all the ossicles': {'clinical finding': 'all the ossicles', 'existence': 'pos_dx', 'descriptive_term': 'all the', 'observation': 'ossicle', 'quantity_term': 'all'}}anatomical entity_fin: {'fluid': {}}clinical findings_fin: {'large surgical cavity': {'clinical finding': 'large surgical cavity', 'cf_snomed': {'cavity': 2483006}, 'existence': 'pos_dx', 'descriptive_term': 'large surgical', 'observation': 'cavity', 'strength_term': 'large'}}object_fin: ['surgical clips']clinical findings_fin: {'surgical clips': {'clinical finding': 'surgical clips', 'existence': 'pos_dx', 'descriptive_term': 'surgical', 'observation': 'clip'}, 'fixation screw': {'clinical finding': 'fixation screw', 'existence': 'pos_dx', 'descriptive_term': 'fixation', 'observation': 'screw'}}anatomical entity_fin: {'mastoid air cells': {}}clinical findings_fin: {'few remaining mastoid air cells': {'clinical finding': 'few remaining mastoid air cells', 'existence': 'pos_dx', 'descriptive_term': 'few remaining mastoid air', 'observation': 'cell', 'quantity_term': 'few'}}anatomical entity_fin: {'sphenoid sinus': {}}location descriptor_fin: ['adjacent', 'right']clinical findings_fin: {'significant bony thinning': {'clinical finding': 'significant bony thinning', 'existence': 'pos_dx', 'descriptive_term': 'significant bony', 'observation': 'thinning'}, 'patent': {'clinical finding': 'patent', 'existence': 'neg_dx', 'observation': 'patent'}}anatomical entity_fin: {'middle ear cavity': {}}imaging observation_fin: ['soft tissue density']clinical findings_fin: {'postoperative changes': {'clinical finding': 'postoperative changes', 'existence': 'pos_dx', 'descriptive_term': 'postoperative', 'observation': 'change'}, 'soft tissue density': {'clinical finding': 'soft tissue density', 'existence': 'pos_dx', 'descriptive_term': 'soft tissue', 'observation': 'density'}}clinical findings_fin: {'bony irregularity': {'clinical finding': 'bony irregularity', 'existence': 'pos_dx', 'descriptive_term': 'bony', 'observation': 'irregularity'}, 'lytic changes': {'clinical finding': 'lytic changes', 'existence': 'pos_dx', 'descriptive_term': 'lytic', 'observation': 'change'}, 'thinning': {'clinical finding': 'thinning', 'existence': 'pos_dx', 'observation': 'thinning'}}clinical findings_fin: {'postsurgical changes': {'clinical finding': 'postsurgical changes', 'existence': 'unc_dx', 'descriptive_term': 'postsurgical', 'observation': 'change'}, 'changes': {'clinical finding': 'changes', 'existence': 'unc_dx', 'observation': 'change'}, 'prior infections': {'clinical finding': 'prior infections', 'existence': 'unc_dx', 'descriptive_term': 'prior', 'observation': 'infection'}}clinical findings_fin: {'osteomyelitis': {'clinical finding': 'osteomyelitis', 'cf_snomed': {'osteomyelitis': 60168000}, 'existence': 'unc_dx', 'observation': 'osteomyelitis'}}anatomical entity_fin: {'wall': {}, 'carotid canal': {}}clinical findings_fin: {'intact': {'clinical finding': 'intact', 'existence': 'neg_dx', 'observation': 'intact'}, 'lytic changes': {'clinical finding': 'lytic changes', 'existence': 'neg_dx', 'descriptive_term': 'lytic', 'observation': 'change'}, 'direct extension': {'clinical finding': 'direct extension', 'existence': 'unc_dx', 'descriptive_term': 'direct', 'observation': 'extension'}}anatomical entity_fin: {'carotid canal': {}}location descriptor_fin: ['lateral']clinical findings_fin: {'air density': {'clinical finding': 'air density', 'existence': 'pos_dx', 'descriptive_term': 'air', 'observation': 'density'}}anatomical entity_fin: {'jugular fossa': {}}clinical findings_fin: {'intact': {'clinical finding': 'intact', 'existence': 'neg_dx', 'observation': 'intact'}}anatomical entity_fin: {'temporomandibular joint': {}}clinical findings_fin: {'intact': {'clinical finding': 'intact', 'existence': 'neg_dx', 'observation': 'intact'}}anatomical entity_fin: {'cochlea': {}, 'vestibule': {}, 'semicircular canals': {}}clinical findings_fin: {'intact': {'clinical finding': 'intact', 'existence': 'neg_dx', 'observation': 'intact'}}anatomical entity_fin: {'right temporal lobe': {'location descriptor': 'inferior'}}location descriptor_fin: ['inferior']clinical findings_fin: {'hypoattenuation': {'clinical finding': 'hypoattenuation', 'existence': 'pos_dx', 'observation': 'hypoattenuation'}}anatomical entity_fin: {'external auditory canal': {}}clinical findings_fin: {'clear': {'clinical finding': 'clear', 'existence': 'neg_dx', 'observation': 'clear'}}anatomical entity_fin: {'tympanic membrane': {}}clinical findings_fin: {'tympanic membrane is faintly visualized': {'clinical finding': 'tympanic membrane is faintly visualized'}}anatomical entity_fin: {'mastoid air cells': {}}clinical findings_fin: {'mastoid air cells': {'clinical finding': 'mastoid air cells', 'existence': 'pos_dx', 'descriptive_term': 'mastoid air', 'observation': 'cell'}, 'clear': {'clinical finding': 'clear', 'existence': 'neg_dx', 'observation': 'clear'}}anatomical entity_fin: {'tegmen tympani': {}}clinical findings_fin: {'intact': {'clinical finding': 'intact', 'existence': 'neg_dx', 'observation': 'intact'}}anatomical entity_fin: {'inner ear': {}}clinical findings_fin: {'inner ear structures have a normal morphology': {'clinical finding': 'inner ear structures have a normal morphology'}}anatomical entity_fin: {'cochlea': {}, 'vestibule': {}, 'semicircular canals': {}, 'facial nerve': {}}clinical findings_fin: {'intact': {'clinical finding': 'intact', 'existence': 'neg_dx', 'observation': 'intact'}}anatomical entity_fin: {'vestibular aqueduct': {}}clinical findings_fin: {'normal limits in size': {'clinical finding': 'normal limits in size'}}anatomical entity_fin: {'internal auditory canal': {}}clinical findings_fin: {'abnormalities': {'clinical finding': 'abnormalities', 'existence': 'neg_dx', 'observation': 'abnormality'}} [/INST] . There are extensive postoperative changes from prior mastoidectomy including removal of all the ossicles. There is fluid and air within a large surgical cavity. Surgical clips and fixation screw are noted at the tegmentum tympani. The few remaining mastoid air cells are opacified. There is significant bony thinning adjacent to the right sphenoid sinus, although the sphenoid sinus has normal signal characteristics and appears patent on prior MRI study. Within the middle ear cavity, there are postoperative changes with small pockets of air and soft tissue density. There are multiple areas of bony irregularity and lytic changes with thinning of the bone. This may represent postsurgical changes, or changes associated with episodes of prior infections. Osteomyelitis cannot entirely be excluded. The bony wall of the carotid canal is intact without lytic changes to suggest direct extension. There is air density immediately lateral to the carotid canal. The jugular fossa is intact. The temporomandibular joint is intact. The bony coverings of the cochlea, vestibule, and semicircular canals are intact. Again seen is an area of hypoattenuation within the inferior right temporal lobe which is better characterized on recent MRI study. The external auditory canal is clear. The tympanic membrane is faintly visualized. The scutum remains sharp. The tympanic cavity and mastoid air cells are clear. The ossicular chain and tegmen tympani are intact. The inner ear structures have a normal morphology. The bony coverings of the cochlea, vestibule, semicircular canals, and facial nerve canal are intact. The vestibular aqueduct is within normal limits in size. No abnormalities of the osseous internal auditory canal are demonstrated. </s>