Squamous cell carcinoma of the right nasal bridge and left cheek with perineural invasion. Status post Mohs 9/9/2014 and radiation therapy completed 12/4/2014. Evaluate for recurrence. There are post-treatment changes in the left cheek, including a mild depression and underlying subcutaneous fat reticulation. However, there is no evidence of measurable mass lesions or significant cervical lymphadenopathy. The thyroid gland appears to be unremarkable. There is mildly asymmetric increased T2 signal diffusely within the left parotid gland, which may represent post-treatment inflammation. The other salivary glans appear unremarkable. The major cervical flow voids are grossly intact. The osseous structures are unremarkable. The orbits and imaged intracranial structures are unremarkable. There is mild scattered paranasal sinus mucosal thickening. There is persistent fluid within the left mastoid air cells and middle ear.
1. No definite evidence of local tumor recurrence, although the assessment is limited by the lack of intravenous contrast.2. No evidence of significant lymphadenopathy in the neck.3. Persistent left otomastoid effusions, which may indicate Eustachian tube dysfunction. 