Diagnosis: Unspecified sinusitis (chronic)Clinical question: intra-operative planning; assess for frontal sinus mucoceleSigns and Symptoms: extensive pansinusitis seen on recent CT scan with bone remodeling There is an expansile mass centered in the right frontal sinus measuring 15 x 29 mm in axial dimensions with predominantly low signal on T2 and intermediate signal on T1. There is enhancement of the mucosal lining of the paranasal sinuses. The mass bulges into the superior aspect of the right orbit and displaces the superior rectus muscle inferiorly. The mass expands into the anterior cranial fossa on the right side and displaces the adjacent right frontal lobe. There is some thickening of the adjacent dura.There is opacification of the paranasal sinusesThe CSF spaces are appropriate for the patient's stated age with no midline shift. No abnormal enhancing mass lesions are appreciated intracranially. No intracranial hemorrhage is identified. No edema is identified within the brain parenchyma.Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus.The visualized portions of the mastoid air cells are clear.
1.Findings are compatible with a mucocele involving the right frontal sinus and expanding into the right anterior cranial fossa and right orbit. There is some associated dural reaction adjacent to this mucocele.2.Opacification of the paranasal sinuses and superior aspect of the nasal cavity is suggestive of polyposis. The possibility of associated infection cannot be excluded