 NECK: There are extensive postoperative findings related to right orbital and sinonasal exenteration with myocutaneous flap reconstruction. The lesion in the roof of the left posterior nasopharynx along the surgical margin is no longer measurable. The previously demonstrated punctate right temporal scalp subcutaneous tissues nodule is not apparent. The right temporal fossa enhancing lesion with an adjacent underlying calvarial defect, right squamosal temporal bone calvarial lesion with extension into the overlying scalp has decreased in size, and right mandibular body lesion are not significantly changed. There is unchanged asymmetric enhancement in the right foramen rotundum. There are persistent obstructed secretions in the frontal and sphenoid sinuses and mucosal thickening and fluid in the left maxillary sinus. There is nonspecific high T2 signal in the bilateral mastoid air cells. There is no evidence of significant lymphadenopathy in the neck. The thyroid and salivary glands appear unchanged.BRAIN: There is no abnormal intraparenchymal enhancement, acute infarct, mass, herniation, or midline shift. There are unchanged scattered T2 hyperintensities in the subcortical and periventricular white matter, which are nonspecific. The ventricles and sulci are unchanged.
1.Unchanged metastases in the skull and mandible, but no measurable residual tumor in the left posterior nasopharynx along the surgical margin and in the right scalp.2.Persistent mild asymmetric enhancement in the right foramen rotundum may be post-treatment in nature.3.No evidence of brain metastases.4. Findings suggestive of acute left maxillary sinusitis with otherwise persistent obstructed secretions associated with the exenteration flap. 