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.

scholarly journals Silent sinus syndrome - Case presentation

2016 ◽  
Vol 6 (21) ◽  
pp. 45-48
Author(s):  
Veronica Trombitas ◽  
Alina Nagy ◽  
Diana Vlad ◽  
Aranka Ilea ◽  
Silviu Albu
Keyword(s):  
Case Report ◽  
Ct Scan ◽  
Maxillary Sinus ◽  
Facial Asymmetry ◽  
Orbital Floor ◽  
White Female ◽  
Correct Treatment ◽  
Case Presentation ◽  
Silent Sinus Syndrome ◽  
Nasal Symptoms

Abstract BACKGROUND. Silent sinus syndrome (SSS) is known as a relatively new pathology with clinical characterizations, represented by the facial asymmetry determined by progressive enophthalmos and hypoglobus and the absence of nasal symptoms. The theory that sustained this pathology is based on the negative maxillary pressure and the chronic evolution of symptomatology. CASE REPORT. A 49-year-old white female presented in our clinic for facial asymmetry, right facial pressure, right depression of the orbital floor and hypoglobus, without diplopia. The CT scan showed an opaque right maxillary sinus with the depression of the orbital floor. CONCLUSION. The pathogenesis, clinical and imagistic features are the most important in the SSS for diagnosis and correct treatment.

scholarly journals Silent sinus syndrome: dynamic changes in the position of the orbital floor after restoration of normal sinus pressure

2011 ◽  
Vol 125 (12) ◽  
pp. 1239-1243 ◽  
Author(s):  
R Sivasubramaniam ◽  
R Sacks ◽  
M Thornton
Keyword(s):  
Case Series ◽  
Sinus Surgery ◽  
Orbital Floor ◽  
Dynamic Changes ◽  
Second Stage ◽  
Silent Sinus Syndrome ◽  
Normal Sinus ◽  
Orbital Floor Reconstruction ◽  
Over Time ◽  
Sinus Pressure

AbstractBackground:Silent sinus syndrome is characterised by spontaneous enophthalmos and hypoglobus, in association with chronic atelectasis of the maxillary sinus, and in the absence of signs or symptoms of intrinsic sinonasal inflammatory disease. Traditionally, correction of the enophthalmos involved reconstruction of the orbital floor, which was performed simultaneously with sinus surgery. Recently, there has been increasing evidence to support the performance of uncinectomy and antrostomy alone, then orbital floor reconstruction as a second-stage procedure if needed.Methods:We performed a retrospective review of 23 cases of chronic maxillary atelectasis managed in our unit with endoscopic uncinectomy and antrostomy alone. All patients were operated upon by the same surgeon.Results:Twenty-two of the 23 patients had either complete or partial resolution. One patient had ongoing enophthalmos, and was considered for an orbital floor reconstruction as a second-stage procedure.Conclusion:Our case series demonstrates that dynamic changes in orbital floor position can occur after sinus re-ventilation. These findings support the approach of delaying orbital floor reconstruction in cases of silent sinus syndrome treated with sinus re-ventilation, as such reconstruction may prove unnecessary over time.

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.

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.

Orbital floor reconstruction planning in the course of silent sinus syndrome using online fab lab – case report

2015 ◽  
Vol 68 (1) ◽  
pp. 95-103
Author(s):  
Paweł Berczyński ◽  
Tomasz Smektała ◽  
Dorota Oskwarek ◽  
Krzysztof Dowgierd ◽  
Grzegorz Trybek ◽  
...  
Keyword(s):  
Case Report ◽  
Orbital Floor ◽  
Silent Sinus Syndrome ◽  
Orbital Floor Reconstruction ◽  
Reconstruction Planning

scholarly journals Spontaneous silent sinus syndrome (imploding antrum syndrome): case series of 16 patients

2011 ◽  
Vol 49 (3) ◽  
pp. 315-317
Author(s):  
H. Babar-Craig ◽  
H. Kayhanian ◽  
D.J. De Silva ◽  
G.E. Rose ◽  
V.J. Lund
Keyword(s):  
Maxillary Sinus ◽  
Endoscopic Sinus Surgery ◽  
Case Series ◽  
Sinus Surgery ◽  
Orbital Floor ◽  
Silent Sinus Syndrome ◽  
Ostiomeatal Complex ◽  
Sinus Drainage ◽  
Ophthalmic Hospital

INTRODUCTION: Silent sinus syndrome (SSS) is a rare idiopathic collapse of the maxillary sinus and orbital floor. We present the second largest series of sixteen patients with SSS and describe their management. METHODS: A cohort of 16 patients with spontaneous SSS between 1999 and 2009 were reviewed at the Royal National Throat Nose and Ear Hospital. All patients were initially referred from a postgraduate ophthalmic hospital, Moorfields Hospital. RESULTS: Fourteen patients required endoscopic sinus surgery to re-establish maxillary sinus drainage and the remaining two settled with intranasal medical therapy consisting of steroids and decongestions. Follow- up ranged from 6 months to 4 years with a mean of 2.6 years. An improvement in enophthalmos and was seen in all surgically treated patients with a mean improvement of 2.2mm and range 0.5-4mm. DISCUSSION: SSS arises from congestion of the ostiomeatal complex resulting in negative pressure within the maxillary sinus and a gradual implosion of the antral cavity. Endoscopic sinus surgery successfully re-establishes maxillary aeration in our series and leads to clinical and aesthetic improvement in the degree of enophthalmos and has avoided the need for orbital floor repair in all but two cases.

scholarly journals Silent Sinus Syndrome: A Case Report and Review of Literature

2013 ◽  
Vol 6 (3) ◽  
pp. 144-148 ◽  
Author(s):  
B Satheesh Kumar Bhandary ◽  
Vadisha Bhat ◽  
Marina Saldanha ◽  
Sebin Tom Scaria
Keyword(s):  
Case Report ◽  
Ct Scan ◽  
Maxillary Sinus ◽  
Facial Asymmetry ◽  
Rare Condition ◽  
Review Of Literature ◽  
Silent Sinus Syndrome ◽  
Middle Meatal Antrostomy ◽  
Exact Etiology

ABSTRACT Silent sinus syndrome is a rare condition affecting the maxillary sinus, resulting in spontaneous collapse of the sinus walls causing facial asymmetry and unilateral enophthalmos. The exact etiology of this condition is unknown. We report a case of a 20-year-old male presented with facial asymmetry with depression of right cheek associated with heaviness over right cheek, without any disturbance of vision or eye movement. Computed tomography (CT) scan of the paranasal sinus showed a relatively smaller and opacified right maxillary sinus with inward retraction of the roof, medial and posterolateral walls. He underwent endoscopic middle meatal antrostomy. On follow-up, patient is free of symptoms and the CT scan showed well-ventilated sinuses with arrest of the disease progression. How to cite this article Saldanha M, Bhat V, Bhandary BSK, Scaria ST. Silent Sinus Syndrome: A Case Report and Review of Literature. Clin Rhinol An Int J 2013;6(3):144-148.

Sign in / Sign up

Export Citation Format

Share Document