History of olfactory neuroblastoma and CRT. Orbits: There are postoperative findings related to sinonasal surgery and bifrontal craniotomy. There is unchanged minimal distortion of the right medial rectus muscle, which may be due to scar tissue formation. Otherwise, the orbital contents are unremarkable, without evidence of mass lesions. There is diffuse mild mucosal thickening and enhancement along the medial margin of the right lamina papyracea and along the reconstructed ethmoid roof. There is also moderate mucosal thickening and enactment within the remaining portions of the inferior right maxillary sinus and mild mucosal thickening within the sphenoid sinuses. There is also a new air-fluid level within the left maxillary sinus. There is unchanged diffuse enhancement within the obliterated frontal sinus bed. The right pterygopalatine fossa, foramen rotundum, Vidian canal, and foramen ovale appear intact. The left orbit is unremarkable. Brain: There is slight interval decrease in size of the enhancing tissue in the surgical bed along the right ethmoid roof. There are minimal nonspecific scattered foci of T2 hyperintensity in the cerebral white matter. There is no evidence of intracranial hemorrhage or acute infarct. The ventricles are unchanged in size and configuration. There is no midline shift or herniation.
1. Post-treatment findings in the sinonasal region with slight interval decrease in size of the enhancing tissue in the surgical bed along the right ethmoid roof, which is likely treatment-related, but otherwise no convincing evidence of recurrent olfactory neuroblastoma.2. New fluid within the left maxillary sinus may represent acute sinusitis, in the appropriate clinical setting.