 There is motion degradation limiting evaluation. There is more prominent ill-defined heterogeneous enhancement in the left masticator space extending toward the left parotid space which could be due to post treatment change. There is unchanged but more prominently enhancing tumor surrounding the left foramen ovale, which may also be due to posttreatment change. There remains enhancement of the left Vidian nerve, left pterygopalatine fossa, and left foramen ovale as well as rotundum, with left V2 and V3 involvement. There remains erosion of the left pterygoid plates and persistent heterogeneous enhancement of the clivus. There is fluid within the left middle ear and mastoid air cells. The major flow voids are intact. The orbits are unremarkable. No suspicious enhancement is seen within the brain parenchyma.
Motion degraded exam with no significant interval change in post treatment findings related to left nasopharynx adenoid cystic carcinoma with perineural spread as described above.