History of right ear tumor. There is avid nodular enhancement centered in the right geniculate ganglion with extension along the tympanic segment of the facial nerve, which measures up to 8 mm. The bilateral internal auditory canals and labyrinthine structures otherwise appear unremarkable. There are secretions and/or mucosal thickening in the bilateral mastoid air cells. There is a T1 hyperintense and T2 hypointense nodule within the pituitary gland that measures up to 9 mm. The cerebellar tonsils are mildly low-lying, which is unchanged. There is no evidence of intracranial hemorrhage or acute cerebral infarct. The brain parenchyma appears unremarkable. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift. There are also secretions and mucosal thickening throughout the left maxillary sinus and left anterior ethmoid air cells. There is prominence of the adenoids and an enlarged left lateral node of Rouviere that measures up to 9 mm in short axis. There are bilateral lens implants. The orbits otherwise appear unremarkable.
1. Nodular enhancement centered in the right geniculate ganglion with extension along the tympanic segment of the facial nerve measuring up to 8 mm likely represents a facial nerve schwannoma and appears unchanged since 2007. 2. A pituitary lesion measuring up to 9 mm likely represents a Rathke cleft cyst and appears unchanged since 2007.3. Left ostiomeatal unit inflammatory changes.4. Secretions and/or mucosal thickening in the bilateral mastoid air cells may represent mastoiditis. 5. Nonspecific prominence of the adenoids and an enlarged left lateral node of Rouviere that measures up to 9 mm in short axis. Although this appears unchanged since 2007, further evaluation via endoscopy may be useful. 6. Unchanged mildly cerebellar tonsils.