Hello doctor, I currently have MS and receive Tysabri as a treatment. During my recent MRI, several things showed up, which have been dismissed out of hand by my MS Provider. 1. In comparison to previous scans, there is a new focus of increased signal change in the right temporal lobe medially adjacent to the third horn 2. Inflammatory changes noted in the ethmoid and maxillary sinuses with a large polyp or retention cysts in the maxillary sinuses. Do any of these require further investigation and can any of these be a reason for hearing loss?
Hello.  I have read your question carefully, and I will try to answer in detail. I understand your concern. I would like to have additional information please, 1. Since when you have the diagnosis of MS and for how long are you on Tysabri (Natalizumab)? 2. When was your hearing damaged and did you have the MRI for this symptom or any other new symptoms or was it a routine imaging check-up for MS? Actually, the MRI report did not show up a number of new things. Except the tiny new plaque which we expect from time to time in MS (the definition of MS is distributed in time and space). Also, none of the plaques are active. Regarding the inflammatory changes and retention cyst in maxillary sinuses, you shouldn't worry. Most of them are asymptomatic and incidental findings during head imaging (radiography, CT, MRI) and are not related to MS. However if you have symptoms like headache, frequent infections of sinuses, facial pain, etc., then you could consult a maxillofacial surgeon, to evaluate you for possible surgical treatment.  I would recommend doing regular follow-ups with your treating physician, and I would not recommend an additional investigation. However, a consult with an ENT doctor is advisable for the differential diagnosis of hearing loss, since the hearing loss is an uncommon symptom in MS. I hope my answer was helpful. Feel free to contact me again with additional information, and if you have further questions.