13-year-old male with neurofibromatosis. Periorbital neurofibroma causing ptosis. Please provide craniofacial protocol. There is redemonstration of a soft tissue mass located along the right eyelid along the extraconal space on the right side along the superior and temporal aspect of the right orbit which goes as far back as the posterior aspect of the right eye. It does extends into the expected location of the right lacrimal gland. This known to represent a plexiform neurofibroma based on clinical history. This is stable in overall morphology and extent compared to the MRI from 8/15/09. There is associated enophthalmus and inferior displacement of the eye on the right side.There is opacification of the right maxillary sinus. the right maxillary sinus is smaller than its left counterpart and almost completely involuted. Mastoid air cells and middle ears are clear.
1.Findings consistent with plexiform neurofibroma involving the right eyelid with extending into the right lacrimal fossa and adjacent extraconal space with no intraconal extension. There is associated enophthalmus and inferior displacement of the eye on the right side. In part this displacement and enophthalmos may also be related to right maxillary sinus atelectasis (silent sinus syndrome).2.Small opacified right maxillary sinus consistent with hypoplasia of the right maxillary sinus. Please correlate with clinical history for silent sinus syndrome or prior trauma.