1. Your nasal polyps appear to be bilateral, involving the frontal and ethmoid sinuses on both sides and more on the left. This suggests an inflammatory / allergic origin. Have you had any nasal symptoms in the past?
2. This nasal polyposis has caused obstruction of the sinus openings and led to the formation of a mucocele
. This slowly growing mucocele has thinned the surrounding bone and eroded it in places by sustained expansion, pressure and chemical changes.
3. You may have to undergo a CT scan to delineate bone and a contrast enhanced MRI to differentiate between other causes of obstructive polyps such as osteomas, inverted papilloma
, malignant or metastatic tumours and so on.
4. Your recent onset drooping eyelid (ptosis) is a result of the expanding mucocele or proptosis
of the left eyeball due to damage to the superior division of the Third Cranial nerve
(Occulomotor Nerve). It should get relieved after treatment. I assume that you have no further eye involvement at present, such as restriction of eye movements, double vision
or visual problems.
5. Surgical decompression by combined endoscopic and external approach may be the best option. You may upload the MRI Images onto a free file sharing site such as www.filesanywhere.com and post a link here.
6. This will also help in examining the size and location of your left middle cranial fossa arachnoid cyst
and deciding about further treatment. At age 67, if it is a primary congenital arachnoid cyst, it may just be an incidental finding and require no treatment. Do you have any history of symptoms related to this cyst?
7. If your nasal polyps are simple polyps of inflammatory / allergic origin, then your outcome after surgery is a positive one.
8. Plan your surgery as soon as possible to avoid certain further complications because any intra-cranial extension of the mucocele can rarely rupture or bleed. Extension or rupture into the orbit may put the optic nerve
9. Treatment of your mucocele comes first. Then the nasal polyps. The arachnoid cyst can wait.
10. You should not be extremely worried. You will do well after surgery.