Findings:
There is a defect of the nasal septum involving the anterior septal cartilaginous area, measuring approximately 1.5 cm. The adjacent mucosa is thickened and nodular.
Accessory maxillary ostium is noted on the right side, measuring approximately 7 mm.
Marked mucoperiosteal thickening and near-complete opacification of the left maxillary sinus is seen with obliteration of the left ostiomeatal complex and demineralization of left-sided nasal conchae, uncinate processes and medial wall of the left maxillary sinus.
Minimal mucosal thickening is seen on the floor of the right maxillary sinus. The ostiomeatal complex on the right is clear.
Mild mucosal thickening is also seen in the left frontal hard sinuses and in ethmoid air cells bilaterally.
The sphenoid sinuses are clear.
Mild soft tissue thickening is seen in the nasopharynx.
Partial obliteration of the mastoid air cells is seen bilaterally. Additional soft tissue density is seen within the left tympanic cavity.
The imaged brain and the orbits are unremarkable.
Conclusion:
Nasal septal perforation involving the anterior septal cartilaginous area.
Left-sided chronic sinusitis, as described above.
Soft tissue thickening in the nasopharynx. Clinical correlation is advised.
Partial obliteration of the mastoid air cells bilaterally as well as soft tissue density within the left tympanic cavity, likely in keeping with bilateral chronic otomastoiditis.