TECHNIQUE:  Routine cone beam computed tomography was performed from the mid orbits through the mandibular base.  Data was acquired as a volume acquisition and reconstructed in multiple planes.  No intravenous contrast was administered. Evaluation of soft tissues is somewhat limited by bone algorithm processing. 

Comparison:  None. 

Findings:   

Airway:   Soft tissue with internal high attenuation occludes the left maxillary sinus and ethmoid air cells. There is similar near complete opacification of the right ethmoid air cells and nasal cavity asymmetrically, left greater than right. There is a large soft tissue mass which extends from the left maxillary sinus into the posterior nasal cavity. The concha and ethmoid walls are attenuated. The osteomeatal units are completely occluded bilaterally. The remaining visualized airways are patent. 

Orbits:   Evaluation limited by technique, however, no gross abnormality noted. 

Oral Cavity:  Visualized mandible, maxilla and dental structures are within normal limits.  The soft tissues of the oral cavity are without radiographically evident abnormality. 

TMJ:  The osseous components of the temporomandibular joints are preserved. 

Other:  No abnormalities 

Impression:

1.   Chronic sinusitis vs. fungal sinusitis involving the maxillary sinuses, ethmoid air cells and nasal cavities, left greater than right.

2.   Left antrochoanal polyp

Recommend referral to primary health care provider vs. Otolaryngologist.