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MRI showed signal abnormality in mastoid air cells and the paranasal sinuses. What are the risks?

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ENT Specialist
Practicing since : 1991
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what does this mean? It's from my 4 year old daughter's MRI results.
There is incidentally seen signal abnormality in the left mastoid air cells and the bilateral and right sphenoid sinuses. Bilateral maxillary mucoperiosteal thickening is seen.
There is also seen signal abnormality in the left mastoid air cells and the paranasal sinuses as described above.
Posted Fri, 20 Jul 2012 in Ear, Nose and Throat Problems
Follow-up: MRI showed signal abnormality in mastoid air cells and the paranasal sinuses. What are the risks? 8 minutes later
FYI: I've called my daughter's neuro every day this week and have received no response. I'm truly stressing over this and I would really like to know what this means as soon as possible PLEEEEEEEASE!
Thank you so very much for this service!
All the best,
Answered by Dr. Sumit Bhatti 2 hours later

Thank you for your query.

1. By the age of four years, most children have hypertrophied adenoid tissue in the nasopharynx. This is normal between the ages of 3-4 and 7-8 years. Adenoids lie near the opening of the eustachian tube which connects the nose to the ear. Hence mastoiditis and fluid accumulation in the middle ear is common in children. The mastoid bone develops after the age of two years.

2. Adenoid hypertophy also commonly causes frequent cold and sinusitis besides many other changes. Many children show abnormal MRI signals in the para nasal sinuses or sinusitis. The para nasal sinuses are normal air containing spaces within the skull and connected to the nasal cavity. In a four year old, the maxillary, ethmoid and small sphenoid sinuses are present. The frontal sinuses are usually yet to develop. These sinuses reach full size many years later.

3. Incidental findings on CT and MRI Scans must be reviewed in the light of clinical signs and symptoms. If she has no symptoms pointing to ear or sinus disease, there is no treatment needed. In small children surgery plays a minimal role as the face and skull is growing. Simple medication (under the supervision of your doctor) will reverse or control the changes. The same applies to the treatment of the pineal cyst. As long as these changes are asymptomatic, they should be left alone.

4. You may get her hearing checked by a PTA (Pure Tone Audiogram) and middle ear fluid or pressures by a Tympanogram (Impedance Audiogram). If these are normal, treatment is not necessary.

5. It will be interesting to review the MRI images for adenoid hypertrophy. You may share them here, if they are available.

6. Let me know if she has any symptoms related to the ears or nose / sinuses. This will help decide any medication. remember that such incidental findings may be very common if all four year olds were screened by an MRI Scan.

7. I must emphasize that there is no cause for worry.

I hope that I have answered your queries. If you have any further questions, I will be available to answer them.

Above answer was peer-reviewed by
Follow-up: MRI showed signal abnormality in mastoid air cells and the paranasal sinuses. What are the risks? 22 hours later
Dear Dr. Bhatti,
I read your response 40 mins after you wrote it yesterday. I replied to the email but realized that you most likely wouldn't have received it.
I want to thank you so much and was very relieved to hear your results.
Ela has had the PTA and Tympanogram done and they have all come back good.
They only provided me with 10 images and I know there's 140 so I'll be requesting the rest of them next week and will download them here for your final review.
I appreciate your help with all my heart and thank you for the work you do! :)
Hope you have a wonderful weekend becuase I sure will with the news that there is no major problems with my daughter's health.
Thank you thank you thank you!!!
Please accept a huge tight hug from me, my husband and my family.
Answered by Dr. Sumit Bhatti 22 hours later

Thank you for writing back.

1. I will review the scan images as you upload them. If the file size is large, you may also share the images via a free file sharing site such as www.4shared .com or WWW.WWWW.WW and share the link here.

2. It is good to hear that her PTA and Tympanogram are normal.

3. Kindly mention symptoms related to the nose and sinuses, if any, that you may have noticed. I will be able to suggest simple medication, if required.

Wishing little Ela good health.

Above answer was peer-reviewed by
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