Clinical question: Evaluate for extent of right nasal mass. Signs and symptoms of right nasal mass. CT of maxillofacial region without infusion:Complete opacification of right chamber of sphenoid sinus consistent with sinusitis. There is no associated bony changes.There is extensive opacification of right ethmoid air cells and right nasal cavity. There is possible partial erosion of the lamina papyracea and bony remodeling and elevation of the floor of the orbit and anterior lamina papyracea. No definitive destructive bony lesion is detected. There is no evidence of extension of soft tissues through the moderate floor of the orbit into the retro-orbital space. There is extensive remodeling of the medial wall of the right maxillary sinus but continuity of the soft tissues within the sinus into the right nasal cavity. There is also deviation of nasal septum to the left with thinning however no destruction. The above findings are believed to represent chronic sinus disease with expansion of the right maxillary sinus and right nasal cavity. Excessive soft tissue within the nasal cavity may indicate polyposis. Possibility of malignancy is considered less likely however further studies with an MRI is recommended to exclude this possibility. Patchy areas of mucoperiosteal thickening within the left chamber of the sphenoid sinus and left maxillary sinus is also present. Limited view of the mastoid air cells demonstrate complete opacification bilaterally however the middle ear cavities are well pneumatized. Soft tissue density within the left external auditory canal is believed to represent debris.
1.Complete opacification of right frontal sinus, right ethmoid sinuses, right nasal cavity and right maxillary sinus with extensive bony remodeling however no bony destruction. Findings are believed to represent long-standing chronic sinus disease with possible nasal polyposis on the right. To exclude the less likely possibility of malignancy and MRI is recommended.2.Chronic sinus disease of the left sided sinuses.