 There is a 4 x 5 mm T2 hyperintense and T1 hypointense lesion within the location of the right geniculate ganglion corresponding to the abnormality on recent CT. The signal intensity is slightly brighter than CSF and there appears to be possibly dura or bone between the lesion and the intracranial compartment, although on CT the bone is very thinned at this level, and may be partially not visualized. Evaluation is limited without intravenous contrast.The internal auditory canals are symmetrical and normal in size. The left inner ear structures are unremarkable. There is a 1 cm T2 hyperintense cystic structure within the midline nasopharyngeal soft tissues most compatible with a Tornwaldt cyst. There is polypoid mucosal thickening within both maxillary sinuses. There is minimal fluid within the mastoid air cells bilaterally.
5 mm lesion within the expected location of the right geniculate ganglion corresponds to the abnormality seen on recent CT. While it is not fully evaluated without contrast, it is suspicious for a cystic facial nerve schwannoma as the normal geniculate ganglion and tympanic segment of the nerve are not visualized as they are on the contralateral side, with a meningocele felt less likely. Further characterization with a contrast exam is suggested.No evidence for IAC lesion on this limited non-contrast exam. 