Silent sinus syndrome and maxillary sinus atelectasis in children

2017 ◽  
Vol 98 ◽  
pp. 150-157 ◽  
Author(s):  
Paolo Farneti ◽  
Vittorio Sciarretta ◽  
Giovanni Macrì ◽  
Ottavio Piccin ◽  
Ernesto Pasquini
Keyword(s):  
Maxillary Sinus ◽  
Silent Sinus Syndrome

Management of the Orbital Floor in Silent Sinus Syndrome

2003 ◽  
Vol 17 (2) ◽  
pp. 97-100 ◽  
Author(s):  
Robert D. Thomas ◽  
Scott M. Graham ◽  
Keith D. Carter ◽  
Jeffrey A. Nerad
Keyword(s):  
Ct Scan ◽  
Maxillary Sinus ◽  
Current Trend ◽  
Ct Scanning ◽  
Volumetric Analysis ◽  
Orbital Floor ◽  
Second Stage ◽  
Silent Sinus Syndrome ◽  
Orbital Floor Reconstruction ◽  
Preoperative Ct

Background Enophthalmos in a patient with an opacified hypoplastic maxillary sinus, without sinus symptomatology, describes the silent sinus syndrome. A current trend is to perform endoscopic maxillary antrostomy and orbital floor reconstruction as a single-staged operation. A two-staged approach is performed at our institution to avoid placement of an orbital floor implant in the midst of potential infection and allow for the possibility that enophthalmos and global ptosis may resolve with endoscopic antrostomy alone, obviating the need for orbital floor reconstruction. Methods A retrospective review identified four patients with silent sinus syndrome evaluated between June 1999 and August 2001. Patients presented to our ophthalmology department with ocular asymmetry, and computerized tomography (CT) scanning confirmed the diagnosis in each case. Results There were three men and one woman, with ages ranging from 27 to 40 years. All patients underwent endoscopic maxillary antrostomy. Preoperative enophthalmos determined by Hertel's measurements ranged from 3 to 4 mm. After endoscopic maxillary antrostomy, the range of reduction in enophthalmos was 1–2 mm. Case 2 had a preoperative CT scan and a CT scan 9 months after left endoscopic maxillary antrostomy. Volumetric analysis of the left maxillary sinus revealed a preoperative volume of 16.85 ± 0.06 cm3 and a postoperative volume of 19.56 ± 0.07 cm3. This represented a 16% increase in maxillary sinus volume postoperatively. Orbital floor augmentation was avoided in two patients because of satisfactory improvement in enophthalmos. In the other two patients, orbital reconstruction was performed as a second-stage procedure. There were no complications. Conclusion Orbital floor augmentation can be offered as a second-stage procedure for patients with silent sinus syndrome. Some patients’ enophthalmos may improve with endoscopic antrostomy alone.

Silent sinus syndrome: an unusual case of facial numbness

2018 ◽  
Vol 18 (6) ◽  
pp. 494-496 ◽  
Author(s):  
Samuel Tribich ◽  
Colin J Mahoney ◽  
Nicholas W Davies
Keyword(s):  
Maxillary Sinus ◽  
Complete Resolution ◽  
Unusual Case ◽  
Clinical Context ◽  
Blurred Vision ◽  
Silent Sinus Syndrome ◽  
Osteomeatal Complex ◽  
Middle Meatal Antrostomy ◽  
Facial Numbness ◽  
History Of

A 49-year-old man presented with a 1-week history of right facial paraesthesia with blurred vision and diplopia. Examination was normal apart from reduced facial sensation. Following appropriate neuroimaging, we considered a diagnosis of silent sinus syndrome. He underwent a middle meatal antrostomy with complete resolution of symptoms. Silent sinus syndrome results from occlusion of the osteomeatal complex, preventing normal aeration of the maxillary sinus. Maxillary sinus hypoventilation typically causes inferior displacement of the globe in the orbit (unilateral hypoglobus). Neurologists will only infrequently see people with silent sinus syndrome but it can have devastating consequences if left untreated and so must be considered in the appropriate clinical context.

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

2014 ◽  
Vol 67 (suppl. 1) ◽  
pp. 65-68
Author(s):  
Ljiljana Jovancevic ◽  
Slobodan Savovic ◽  
Slavica Sotirovic-Senicar ◽  
Maja Buljcik-Cupic
Keyword(s):  
Maxillary Sinus ◽  
Endoscopic Sinus Surgery ◽  
Rare Condition ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Orbital Floor ◽  
Orbital Trauma ◽  
Silent Sinus Syndrome ◽  
Slow Development ◽  
The Right

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.

Silent sinus syndrome associated with natural childbirth

2018 ◽  
Vol 7 (4) ◽  
pp. 1-5
Author(s):  
Aleksandra Sobolewska ◽  
Pedro Clarós
Keyword(s):  
Maxillary Sinus ◽  
Nasal Congestion ◽  
Rare Condition ◽  
Orbital Floor ◽  
Ipsilateral Side ◽  
Natural Childbirth ◽  
Silent Sinus Syndrome ◽  
Unusual Association ◽  
History Of ◽  
One Step

Spontaneous, painless enophthalmos, hypoglobus with orbital floor resorption and maxillary sinus collapse on the ipsilateral side is recognised as a rare condition known as the silent sinus syndrome. This paper aimed to present an unusual association of natural childbirth and the onset of orbital floor displacement caused by silent sinus syndrome. We wanted to present a case of a 31-year-old woman presented with a 3-month history of painless, progressive right enophthalmos otherwise utterly asymptomatic who developed symptoms shortly after natural childbirth. That association have never been presented before in literature. We also wanted to discuss the pregnancy-related nasal congestion. We present our experience with these case treated with a single-stage procedure, focusing on the advantages of this one-step approach.

scholarly journals Silent Sinus Syndrome: Interesting Computed Tomography and Magnetic Resonance Imaging Findings

2020 ◽  
Vol 10 ◽  
pp. 38
Author(s):  
Fahad B. Albadr
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Magnetic Resonance ◽  
Maxillary Sinus ◽  
Imaging Findings ◽  
Resonance Imaging ◽  
Sinus Disease ◽  
Silent Sinus Syndrome ◽  
Parry Romberg Syndrome ◽  
Key Features

Silent sinus syndrome (SSS) is the spontaneous unilateral collapse of the maxillary sinus and orbital floor with complete or partial opacification of the collapsed sinus. The key features in a patient who presents with SSS are painless progressive unilateral maxillary sinus disease in the absence of rhinosinusitis, trauma, or surgery. SSS is a rare disorder but could be under-diagnosed because of a lack of recognition. SSS is characterized by spontaneous and progressive enophthalmos (“sunken” eye-eye recession into the globe) and hypoglobus (globe displaced downward; and a drop in the pupillary level), so it is common for these patients to present first to an ophthalmologist. Although mostly observed in adults, there have been reports of SSS in children. SSS in younger individuals has characteristic clinical and radiologic signs with, in many cases, abnormal intranasal anatomic characteristics on the affected side. SSS should be differentiated from other causes of spontaneous enophthalmos, such as Parry-Romberg syndrome and linear scleroderma. The aim of this report was to alert the reader to the imaging findings in patients with SSS. This syndrome is well recognized by rhinologists and to a lesser extent to ophthalmologists but remains relatively unknown to general radiologists.

Maxillary Sinus Wall Thickening in Silent Sinus Syndrome

2017 ◽  
Vol 135 (5) ◽  
pp. e170637 ◽  
Author(s):  
Gonzalo Varas ◽  
Peter J. Dolman
Keyword(s):  
Maxillary Sinus ◽  
Wall Thickening ◽  
Silent Sinus Syndrome ◽  
Sinus Wall

Silent Sinus Syndrome: Lack of Orbital Findings in Early Presentation

2007 ◽  
Vol 21 (4) ◽  
pp. 489-494 ◽  
Author(s):  
Sarah K. Wise ◽  
Ted H. Wojno ◽  
John M. DelGaudio
Keyword(s):  
Ct Scan ◽  
Maxillary Sinus ◽  
Tertiary Care ◽  
Disease Process ◽  
Uncinate Process ◽  
Early Presentation ◽  
Presenting Symptoms ◽  
Silent Sinus Syndrome ◽  
Uncommon Disease ◽  
Radiological Studies

Background Silent sinus syndrome (SSS) is an uncommon disease process, classically described as unilateral maxillary sinus opacification that presents with enophthalmos and atelectasis of bony sinus walls from chronic negative pressure. Patients are largely free of characteristic rhinosinusitis symptoms. Methods Operative reports, clinic notes, and radiological studies were reviewed for cases of SSS treated in a tertiary care institution over a 7-year period. Presenting symptoms, radiological features, and surgical findings were evaluated. Results Seventeen cases of SSS were identified. Presentation ranged from incidental computed tomography (CT) scan findings to unilateral enophthalmos with altered midface anatomy. Facial pain ipsilateral to the disease process occurred in 30% of cases. Vision changes were uncommon. Radiological studies universally revealed an opacified maxillary sinus on the affected side. Maxillary sinus walls were contracted and demineralized with significant orbital floor depression in 11 advanced cases. Four early cases revealed only lateralized uncinate process on CT scan without increased orbital volume, and two moderate cases showed increased orbital volumes on CT scan without clinical enophthalmos. All patients had a significantly lateralized uncinate process at surgery, often closely apposed to demineralized orbital walls. Conclusion Some authors maintain that SSS presentation must include enophthalmos. However, our series shows cases of lateralized uncinate processes and increased orbital volumes on CT scan, as would be seen in classic SSS, but lacking clinical enophthalmos. Such cases should be considered as potentially representing early SSS, before the development of clinical orbital findings.

Prevalence of Maxillary Sinus Hypoplasia and Silent Sinus Syndrome: A Radiological Cross-Sectional Retrospective Cohort Study

2021 ◽  
pp. 194589242110294
Author(s):  
Umberto D’Agostino Fiorenza ◽  
Chiara Spoldi ◽  
Liudmila Nekrasova ◽  
Carlotta Pipolo ◽  
Paolo Lozza ◽  
...  
Keyword(s):  
Cohort Study ◽  
Maxillary Sinus ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Septal Deviation ◽  
Ct Scans ◽  
Concha Bullosa ◽  
Cross Sectional ◽  
Silent Sinus Syndrome ◽  
Maxillary Sinus Hypoplasia

Background Maxillary sinus hypoplasia (MSH), associated with enophthalmos and hypoglobus in the silent sinus syndrome (SSS), is a poorly studied condition. The real incidence of MSH and SSS in the adult population is not known. Our study aims at estimating the radiological prevalence of MSH and identifying undiagnosed cases of SSS in a retrospective cohort. Methods A cross-sectional retrospective cohort study was performed in adults, without a history of maxillofacial surgery or trauma, undergoing head CT scans. A radiological database of 1012 consecutive scans was reviewed independently by two authors to identify patients with signs of MSH and SSS and associated findings (septal deviation, uncinate deviation, concha bullosa, sinus opacification, bony rarefaction, and pterygopalatine fossa enlargement). The findings of MSH and SSS were compared with radiological reports. Results 891 eligible CT scans were analyzed. MSH and SSS prevalences were 6.17% (n = 55) and 0,56% (n = 5), respectively. The maxillary sinus was normally or partially ventilated in 96.36% of MSH patients. Lateralization of the uncinate process was detected in about 50% of MSH patients, while a septal deviation towards the affected sinus was detected in 21.82%. In 20% of MSH scans, a concha bullosa was identified. Radiological reports identified a single MSH case. Conclusions Our study confirmed the literature data on MSH prevalence, while it determined a precedently unknown prevalence for SSS, underestimated in the radiology reports. This prevalence needs further confirmation but suggests a routine accurate comparison of both maxillary sinuses in CT scans.

Case report of two patients with silent sinus syndrome

2021 ◽  
Vol 20 (3) ◽  
pp. 115-120
Author(s):  
G. P. Zakharova ◽  
◽  
N. I. Ivanov ◽  
Keyword(s):  
Surgical Treatment ◽  
Maxillary Sinus ◽  
Clinical Course ◽  
Facial Asymmetry ◽  
Primary Diagnosis ◽  
Lower Wall ◽  
Valve Mechanism ◽  
Silent Sinus Syndrome ◽  
Clinical Observations ◽  
The Face

SMS is a rare pathology of the paranasal sinuses, accompanied by such symptoms as pain in the eye area, enophthalmos and hypophthalmos on the side of the localization of the process, facial asymmetry caused by a decrease in the volume of the maxillary sinus due to its atelectasis in the presence of chronic inflammation in it. The disease, as a rule, proceeds under the primary diagnosis of chronic rhinosinusitis. The main pathogenetic link of the disease is generally accepted as the block of the anastomosis and the emergence of the valve mechanism of ventilation of the maxillary sinus. However, the immediate cause of the onset of atelectasis remains a subject of discussion to this day. The only effective surgical treatment is to restore ventilation of the maxillary sinus by expanding the anastomosis and eliminating the cause of its block. With a pronounced asymmetry of the face due to the lowering of the orbit, the plastic of the lower wall of the orbit is performed. The article discusses modern ideas about the silent sinus syndrome, its etiology, pathogenesis, clinical course and treatment tactics for patients, presents two clinical observations of patients with silent sinus syndrome and describes the options for surgical treatment and its results.

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