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MRI shows completely filled sinus. Had ameloblastoma in maxillary sinus removed. Worried

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Dear doctors,
An uni-cystic ameloblastoma of size 4.2x3.5x3cm was found in my left maxillary sinus 14 months ago. I underwent a Le Fort I to have the tumor removed. Few days ago, I went for the annual check-up and the doctor ordered me a MRI to see whether everything is ok.
Unfortunately the images showed a completely filled left sinus. Both T1 and T2 weighted showed grey, similar to the color of tongue. My next doctor visit will be 15 days later. Right now I am indeed worried and would really like to know what the thing is in my left sinus. At the moment I don't have any symptoms apart from that the 4 teeth located below the tumor are moving little since the roots of these teeth were partially absorbed by the tumor last year.

Thanks for any usual information.
AAAAA
Posted Sun, 30 Sep 2012 in Ear, Nose and Throat Problems
 
 
Answered by Dr. Naveen Kumar 1 hour later
Hi XXXXXXX

Thanks for posting the query

The left maxillary sinus in the MRI shows hypertrophy of the sinus mucosa and polyp formation post excision of the tumor. It is very unusual for the ameloblastoma to recur so early (the average period for recurrence is 7 years) as it is a benign tumor.

CT scan of the paranasal sinuses would have been a better investigation of choice than MRI, as the bony details of the sinus cavities gets well defined in CT scan which helps us in assessing the extent of bony destruction as well as contents inside the sinus.

In the present MRI scan, the left sinus is filled with secretions and polyps which are evidenced by the pockets of air along the margins of the sinus and blockage of the opening of the sinus. The blockage of the sinus with collection of the secretions occurs because of the damage to the mucosal lining during previous surgery. Do not worry! This is completely normal. With appropriate intervention the sinus can be cleared.

Hope I have answered your query; I will be available for the further queries.

Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon
Above answer was peer-reviewed by
 
Follow-up: MRI shows completely filled sinus. Had ameloblastoma in maxillary sinus removed. Worried 3 hours later
Dear Doctor,

Thank you so much for your kind answer which relieve my worry.

What kind of intervention method do you think is required? Would an endoscopy be enough, or would I have to go through a le Fort I again?

As I do not have any symptoms now, would it be XXXXXXX to leave the sinus as it is (I would rather not go through a Le Fort I-surgery again)?

Best regards,
AAA
 
 
Answered by Dr. Naveen Kumar 2 hours later
Hi XXXXXXX

Thanks for writing back

Yes, a nasal endoscopy has to be preformed to relieve the blockage of the osteomeatal complex and clear the contents of the maxillary sinus. The sinus washing thus collected would be sent for histo-pathological examination. I doubt you require a repeat Le Fort surgery.

Even in the absence of the pressure symptoms the contents of the maxillary sinus can exert pressure over the surrounding structures and lead to complications in the future. You will require a nasal endoscopy to assess the anatomical structure and certain medicines to open the sinus block and clear the secretions. If there is no improvement even after the above measures, a simple endoscopic sinus surgery would suffice to clear the contents.

I wish you good health.

Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgery
Above answer was peer-reviewed by
 
Follow-up: MRI shows completely filled sinus. Had ameloblastoma in maxillary sinus removed. Worried 17 hours later
Thank you so much, doctor! Today I receive the lab-report of MRI and it said the same as you told about the fluid in the left sinus and no suspect mass had been found. It seemed to be a chronic inflammation development in my sinus. I will soon discuss with my doctor about the further interventions. Hopefully a nasal endoscopy will be enough to clear the sinus and I do not need to undergo any extensive operation.
 
 
Answered by Dr. Naveen Kumar 7 hours later
Hi XXXXXXX

Welcome back

So, now you can have some peace of mind. Limited endoscopic sinus surgery will be sufficient enough to treat this problem.

I wish you good luck and good health.

Regards
Dr. Naveen Kumar N.
ENT and Head & Neck Surgeon
Above answer was peer-reviewed by
 
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