Asymmetric sensorineural hearing loss and tinnitus. The bilateral cranial nerve 7 and 8 complexes are intact. There is no evidence of mass lesions. The inner ear structures, including the cochlea, vestibule, endolymphatic duct, and semicircular canals, appear unremarkable. The bilateral mastoid air cells and middle ears also appear unremarkable. There is an incompletely outpouching along the medial aspect of the right supraclinoid internal carotid artery that measures at least 5 mm in width. There an enhancing lesion in the left nasal cavity that measures up to 12 x 25 mm, adjacent to the left middle turbinate. There is relatively focal prominence of the median adenoids with intact striations, which likely represents hyperplasia.
1. No evidence of inner ear or retrocochlear lesions.2. An enhancing lesion in the left nasal cavity that appears intimately associated with the left middle turbinate, which may represent a neoplasm. Dedicated sinus imaging or endoscopic examination may be useful for further characterization.3. An incompletely imaged outpouching along the medial aspect of the right supraclinoid internal carotid artery that measures at least 5 mm in width likely represents an aneurysm. Dedicated vascular imaging can be performed for further evaluation. Discussed with Maureen Crowley at 4PM on 7/22/15.