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

Abstract

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.

Volumetric Analysis of Chronic Maxillary Atelectasis

“…Orbit remodeling can occur after successful maxillary antrostomy 4,5,7,15 We have demonstrated volumetrically that the maxillary sinus may reexpand after successful aeration with ESS. The affected orbits were noted to significantly decrease in volume postoperatively (p ϭ 0.005).…”

A child with silent sinus syndrome and spontaneous improvement after sinus surgery

“…Although limited in the number of patients, there have been reports showing spontaneous improvement in enophthalmos and hypoglobus after only the endoscopic antrostomy with no need for orbital floor reconstruction [7,8]. Sivasubramaniam et al performed a restrospective review of 23 patient with silent sinus syndrome and described postoperative changes in the orbital floor via nasal endoscopy and improvement in enophthalmos over time after endoscopic uncinectomy and antrostomy [9]. However, these have all been reported in patients older than 18 years of age.…”

Intracranial pressure and skull remodeling

“…In a series of 23 patients with silent sinus syndrome, following re-establishing aeration of the sinus, 22 patients had partial or complete normalization of globe position. 31 Therefore, observation should be considered following normalization of ICP prior to proceeding with surgical augmentation. When medically necessary or when improvement is not seen following normalization of ICP, surgical intervention may be considered.…”