Patient with chronic maxillary sinus pressure. Please evaluate for sinusitis. CT of paranasal sinuses:Extensive opacification of bilateral maxillary sinuses with mixed high and low density material. This is believed to be secondary to long-standing chronic sinus disease. No definite evidence of any associated bony changes. Less likely possibility of fungal sinusitis cannot be entirely ruled out due to high density of the sinuses.Complete occlusion of bilateral ostiomeatal units.Extensive sinus disease of bilateral ethmoid air cells. Mucoperiosteal thickening in bilateral chambers of the sphenoid sinus.Mucoperiosteal thickening of bilateral frontal sinuses.Images through the nasal cavity demonstrate increased soft tissue density within the nasal cavity which is believed to be secondary to mucoperiosteal thickening. No bony abnormalities detected. Possibility of polyp in particular within the left nasal cavity cannot be entirely ruled out.The osseous structures of the area of the study are unremarkable. Images through the orbits are grossly within normal limits.Visualized mastoid air cells and medullary cavities are within normal limits.MRI examination of brain from 2006 is also reviewed which also demonstrated extensive chronic pansinusitis with more severe involvement of bilateral maxillary sinuses.
1.Extensive pansinusitis and with more significant involvement of bilateral maxillary sinus.2.Extensive soft tissue density within the nasal cavity as detailed.3.No definitive osseous abnormality.4.High density content of maxillary sinuses could be secondary to chronic long-standing sinus disease however possibility of fungal sinusitis cannot be entirely ruled out.