PMC3767070_01
(a) Coronal CT sinus scan and (b) Sagittal CT Sinus scan; 4mm wide bone defect in the anterior cribriform plate just to the right of crista galli, with a small meningoencephalocoele sac as confirmed at surgery. (c) Axial post gadolinium T1W scan showing a small meningocoele in the right anterosuperior nasal cavity with central fluid signal and rim enhancement of adjacent mucosa.
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A coronal CT sinus scan done to investigate his non-specific upper respiratory tract symptoms showed a 4 x 3 mm defect in the cribriform plate adjacent to the vertical attachment of the middle turbinate, a relatively common site for 'congenital' defects (Figure 1).
PMC3767070_02
(a) CT Sinus scan: anomalous 'flask-shaped' anterior ethmoid air cell opacified due to chronic mucocoele. (b) At the root of this air cell, the bone of fovea ethmoidalis is expanded, irregular, partly thickened and partly dehiscent.
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However, detailed sinus CT showed an anomalous, prominent right agger nasi ethmoid air cell extending up to the skull base with sclerotic thickened bony walls and opacification within (Figure 2).