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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Is My MRI Report To Be Concerned ?

I took an MRI last week which was written up as having the following impression by the radiologist ..... I took an MRI last week which was written up as having the following impression by the radiologist Polypoid left greater than right frontal sinus and ethmoid sinus mass with mucocele formation involving the left frontal sinus with extension into the superior orbit Left middle cranial fossa arachnoid cyst Is this something I should be terribly concerned about I am a 67 year old female with a droopy eye lid symptom which I have had for a few months. I was sent for an MRI with contrast by my opthalmologist. I was seen by an ENT a few days after the MRI who contacted a Otorhinolaryngologist at U of Penn where I have an appointment next week. The impression on my MRI report read as follows: Polypoid left greater than right frontal sinus and ethmoid sinus mass with mucocele formation involving the left frontal sinus with extension into the superior orbit. Left middle cranial fossa arachnoid cyst. Is this something I should be extremely concerned about and will my outcome be a positive one?
Wed, 23 Feb 2011
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Otolaryngologist / ENT Specialist,  's  Response
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 at risk.

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.
I find this answer helpful
  Anonymous's Response
Anonymous's  Response
Since I am having trouble with my computer I am sending my answer to you a second time. Thank you very much for your advice and here are a few answers to your questions: 1. The only symptom that I have involving my eye is slight bluriness in my left eye. 2. Nasal symptoms in the past have been a dry nose and when that occurs I use saline drops, I have never had any allergies. The mucocele measures approximately 17 x 22 x 13 mm.
Homeopath,  Dr. KOMAL vig's  Response
hello there.. ur polyp can b cured completely wit the help of homeopathic medicines.. no need of surgery.. consult a homeopath,.. god bless..
I find this answer helpful
  User's Response
barbara Milchman's  Response
I do believe with the diagnosis my MRI shows, homeopathic medicines would not be a fortuitous route for me to take. Thank you anyway.
Note: Consult an experienced Otolaryngologist / ENT Specialist online for further follow up on ear, nose, and throat issues - Book a Call now.
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Is My MRI Report To Be Concerned ?

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 at risk. 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.