The Silent Sinus Syndrome: A Clinical Review

2010 ◽  
Vol 3 (2) ◽  
pp. 69-72
Author(s):  
Natasha Choudhury ◽  
Joe Marais
Keyword(s):  
Gold Standard ◽  
Standard Treatment ◽  
Sinus Surgery ◽  
Orbital Floor ◽  
Younger Patients ◽  
The Third ◽  
Silent Sinus Syndrome ◽  
Orbital Floor Reconstruction ◽  
Negative Pressures ◽  
Sinonasal Disease

Abstract Silent sinus syndrome (SSS) is a rare and interesting clinical condition that is associated with spontaneous, painless, unilateral enophthalmos and hypoglobus resulting from downward bowing of the orbital floor, in the absence of any symptomatic sinonasal disease. It generally affects younger patients between the third and fifth decades of life. The pathogenesis of silent sinus syndrome is based on chronic maxillary sinus obstruction, related to occlusion of the maxillary infundibulum which results in a hypoventilated sinus and negative pressures. Endoscopic sinus surgery to create a wide maxillary antrostomy with or without orbital floor reconstruction is considered the gold standard treatment of choice.

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.

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": 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.

scholarly journals The Profile of Pharmacological Treatment in Trigeminal Neuralgia Patients in The Period of January 2018-December 2018

2020 ◽  
Vol 4 (9) ◽  
pp. 301-305
Author(s):  
Marlon Yutimma Roestam Moenaf ◽  
Maftuchah Rochmanti ◽  
Devi Ariani Sudibyo
Keyword(s):  
Trigeminal Neuralgia ◽  
Gold Standard ◽  
Standard Treatment ◽  
Treatment Guideline ◽  
Pain Scale ◽  
The Third ◽  
Significant Pain ◽  
Keywords Trigeminal Neuralgia ◽  
Almost All ◽  
Scale Data

Trigeminal neuralgia is a condition that affects the trigeminal nerve, that manifests in a series of stabbing like pain, and often described like electricity. Its treatment guideline is to prioritize pharmacotherapy until patient is well. The gold standard treatment for trigeminal neuralgia is pharmacotherapy of Carbamazepine. However, carbamazepine is proven to cause allergic reaction to some patients. This research aims to describe the pharmacotherapy that is given to patients. The regiments of pharmacotherapy in trigeminal neuralgia shows that CBZ is the main pharmacotherapy given, as it is the gold standard treatment. GBP is the is the second most pharmacotherapy given and a concoction medication of Paracetamol, Diazepam and Amitriptyline being the third most favored therapy. Neurotropic B Vitamins plays a big role, as a support in the therapy to maintain the health of the overall nervous system. The pain scale data shows that almost all patients have significant pain relieve. The therapy of trigeminal neuralgia in this study shows that CBZ is most favored as it is the gold standard, however not all AEDs are accessible. Almost all patients have significant pain relieve eventhough not using gold standard treatment. Keywords: trigeminal neuralgia; pharmacotherapy

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 Bilateral Silent Sinus Syndrome: A Rare Case and Review of Literature

2017 ◽  
Vol 8 (2) ◽  
pp. ar.2017.8.0197 ◽  
Author(s):  
Michal Trope ◽  
Joseph S. Schwartz ◽  
Bobby A. Tajudeen ◽  
David W. Kennedy
Keyword(s):  
Rare Case ◽  
Medical Literature ◽  
Case Reports ◽  
Sinus Surgery ◽  
Review Of Literature ◽  
Review Of The Literature ◽  
Previous Surgery ◽  
The Third ◽  
Silent Sinus Syndrome ◽  
Insight Into

Objective In this report, we presented a rare case of bilateral silent sinus syndrome (SSS) in an otherwise healthy 57-year-old man treated with functional endoscopic sinus surgery (FESS). A systematic review of the literature regarding bilateral SSS was performed. Case Report A 57-year-old man with well-controlled allergic rhinitis in the absence of previous surgery or trauma presented with bilateral SSS, which was successfully managed with bilateral FESS. Methods A medical literature data base search of the terms “silent sinus syndrome” “maxillary atelectasis,” “imploding antrum syndrome,” and “bilateral silent sinus syndrome” was performed. The results were then narrowed to include only relevant articles. Results Relevant articles included three case reports and two articles that describe or mention bilateral SSS. Of the three case reports found, two patients presented with bilateral SSS, whereas the third patient presented metachronously, with the contralateral SSS manifesting 4 months after presentation of the initial ipsilateral SSS. Conclusion The present literature regarding bilateral SSS is likely incomplete, and further investigation is required to provide greater insight into the prevalence of this disease. In this report, bilateral FESS was successful in resolving symptoms and preventing disease progression.

Implant Materials Used for Orbital Floor Reconstruction

2020 ◽  
Vol 11 (1) ◽  
pp. 1266
Author(s):  
Mohamed Esmail Khalil ◽  
Mohamed Farag Khalil ◽  
Raafat Mohyeldeen Abdelrahman ◽  
Ahmed Mohamed Kamal Elshafei ◽  
Tamer Ismail Gawdat
Keyword(s):  
Orbital Floor ◽  
Implant Materials ◽  
Orbital Floor Reconstruction ◽  
Materials Used
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