"Silent sinus syndrome": One more indication for functional endoscopic sinus surgery

• Published in: Medicinski pregled Vol. 67; no. suppl. 1; pp. 65 - 68
• Main Authors: Jovancevic, Ljiljana, Savovic, Slobodan, Sotirovic-Senicar, Slavica, Buljcik-Cupic, Maja
• Format: Journal Article
• Language: English
• Published: 2014
• ISSN: 0025-8105; 1820-7383
• DOI: 10.2298/MPNS14S1065J

Introduction. Silent sinus syndrome is a rare condition, characterized by
spontaneous and progressive enophthalmos and hypoglobus associated with
atelectasis of the maxillary sinus and downward displacement of the orbital
floor. Patients with this syndrome present with ophthalmological complaints,
without any nasal or sinus symptoms. Silent sinus syndrome has a painless
course and slow development. It seems to be a consequence of maxillary sinus
hypoventilation due to obstruction of the ostiomeatal unit. The CT scan
findings are typical and definitely confirm the diagnosis of silent sinus
syndrome. Case report. We present the case of a 35-year-old woman, with no
history of orbital trauma or surgery. She had slight righthemifacial pressure
with no sinonasal symptoms. The patient had no double vision nor other
ophthalmological symptoms. The diagnosis of silent sinus syndrome was based
on the gradual onset of enophthalmos and hypoglobus, in the absence of
orbital trauma (including surgery) or prior symptoms of sinus disease. On
paranasal CT scans there was a complete opacification and atelectasis of the
right maxillary sinus with downward bowing of the orbital floor. The patient
was treated with functional endoscopic sinus surgery, with no orbital repair.
Conclusion. Silent sinus syndrome presents with orbithopaties but is in fact
a rhinologic disease, so all ophthalmologists, rhinologists and radiologists
should know about it. The treatment of choice for silent sinus syndrome is
functional endoscopic sinus surgery, which should be performed with extra
care, by an experienced rhinosurgeon.
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