Silent Sinus Syndrome: A Case Report and Review of Literature

Abstract

silent sinus syndrome is surgical, by performing an endoscopic maxillary antrostomy [4]. Most of the patients may remain asymptomatic with well ventilated maxillary sinus, while a few may require orbital floor reconstruction as a second stage procedure [5]. We report a case of a 29-year-old male, presenting with painless enophthalmos and facial asymmetry. Computed tomography (CT) of paranasal sinuses (PNS) showed features of silent sinus syndrome. He underwent an endoscopic maxillary antrostomy which resulted in arrest of disease progression. Case ReportA 29-year-old male presented with a 4 month history of sunken appearance of his left eye, which was insidious in onset and gradually progressive, associated with facial asymmetry. He did not have disturbances in vision or ocular movements. There was no history of facial trauma, surgery of the face, nasal congestion, nasal discharge or any previous history suggestive of chronic sinusitis.His general physical examination and systemic examination was normal. Ophthalmology evaluation was done, vision and ocular movements were found to be normal. He had 2 mm of enophthalmos and 4 mm of hypoglobus. Anterior rhinoscopy and diagnostic nasal endoscopy revealed a septal spur on the left side with normal pink nasal mucosa. Non contrast CT PNS was done, which showed a relatively small left maxillary sinus with inward retraction of the walls. Floor of the orbit and anterolateral walls were seen to have thinned out with resulting increase in the orbital volume causing hypoglobus ( Figure 1A and Figure 1B). There was lateralization of the left uncinate process with obstruction of left osteomeatal complex. Complete AbstractSilent sinus syndrome is a rare clinical entity affecting the maxillary sinus, causing progressive enophthalmos and hypoglobus resulting from retraction of maxillary sinus walls with increase in the orbital volume. We report a case of a 29-year-old male who presented with painless enophthalmos, without any disturbances in vision or ocular movements, with no history of sinusitis in the past. Computed tomography of paranasal sinus showed a relatively small and opacified maxillary sinus with inward retraction of roof, medial and anterolateral walls of maxillary sinus with hypoglobus. He underwent endoscopic middle meatal antrostomy following which he improved symptomatically without any progression of enophthalmos and hypoglobus.