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Patient details :

Mr. Safdar Raza, 40 yrs./M

Chief complaints :

- Nasal blockage and crusting on and odd > 6 months

- Decreased sense of smell and tadte since > 3 months.

Relevant history:

- According to the patient, about 10 years back , he was diagnosed with Chordoma involving the frontal
lobe which was operated through the nasal passage. He has been experiencing nasal crusting and
blockage ever since. However it has become more severe in the past few months.
-Post surgery the patient had serial annual MRIs to rule out recurrence for the first 3 years. He has not
had any scan since.

Examination & Investigations :

- Nasal examination shows a large septal perforation with crusting around it. B/L inferior turbinates are
hypertrophic and b/l middle meati patent.
- Rest of ENT examination is within normal limits.

Provisional Diagnosis /Ddx :

- Hyposmia under investigation

Investigation/Procedure requested :

To rule out any central causes of Hyposmia and to followup on the intracranial pathology that the
patient was treated for , an MRI brain is required. It will also help in alleviating the patient's anxiety .
Kindly provide approval.