 Since prior MRI from 11/3/2015, there has been increase in edema and enhancement involving the occipital condyles, C1, as well as the C2 vertebra, primarily involving the odontoid process. Remainder of the previously seen marrow signal abnormality with low T1 signal and enhancement in the skull base is not significantly changed. There are no new fluid collections or discrete masses in the adjacent soft tissues.There are post-treatment findings in the left nasopharyngeal region with soft tissue deficiency involving the pharyngeal mucosal and left parapharyngeal spaces. No mass to suggest residual or recurrent tumor. No significant cervical lymphadenopathy. Postoperative findings related to left-sided mastoidectomy again seen with fluid in the residual left mastoid air cells. There is also partial right mastoid air cell opacification. Moderate mucosal thickening involving most of the paranasal sinuses again seen. These findings are similar to prior from 11/3/2015.Multilevel degenerative changes are present in the cervical spine with small disc osteophyte complexes and up to moderate spinal canal stenosis at the C3-C4 level. There is also a prominent disc osteophyte complex with ventral indentation of the cord at the C5-C6 levels. These findings are grossly similar to prior. Chronic left cerebellar infarct again seen. Also has seen on recent brain MRI, there are small cysts involving the lacrimal glands.
1. Posttreatment findings in the left nasopharyngeal region without evidence of tumor recurrence.2. No recent neck MRI is available for comparison. Previously seen marrow signal abnormality involving the central skull base with edema and enhancement has progressed compared to 11/3/2015, with new or worsened signal abnormality involving the occipital condyles, C1, and C2 levels. Findings are compatible with progressive osteoradionecrosis/osteomyelitis. No associated fluid collections or masses.