Silent sinus syndrome: One more reason for an ophthalmologist to have a rhinologist as a good friend

Abstract

nema

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

“…[12,18] Given the rarity of SSS and the very high prevalence of obstruction of the maxillary sinus ostium, this theory has come under question. [3] Several authors have demonstrated absolute normality of the maxillary sinus walls before clinical and radiological manifestations of SSS, which confirms that it is an acquired condition. [1,6,12] In this enclosed cavity, subsequent gas resorption leads to sub-atmospheric pressure that creates a vacuum, thus creating a suction effect of negative pressure within the maxillary sinus; this vacuum may induce osteopenia, bone remodeling, and retraction of the sinus walls, similar to retraction in the middle ear caused by Eustachian tube dysfunction.…”

“…e first theory is a progressive development of a small sinus with chronic obstructive sinusitis as an initial cause. [3] Davidson et al [12] and Kass et al [13] have documented negative maxillary sinus pressure in patients with clinical and radiographic characteristics of SSS, supporting the theory of negative maxillary sinus pressure leading to SSS.…”

“…Inflammatory cells can produce cytokines that inhibit the replication of osteoblasts and collagen synthesis, thus favoring the osteopenia process, but the negative pressure in the maxillary sinus must also take part in the mechanism. [3] However, the acquired nature of this condition is now well recognized. Obstruction of the sinus ostium is always present, but it is not clear whether or not this is the cause or result of sinus wall retraction.…”

“…is theory also fails to explain the almost dominant involvement of the maxillary sinus. [1,3] e third theory involves maxillary sinus hypoplasia. Surprisingly, SSS has been reported to be the result of an infection in a congenitally hypoplastic maxillary sinus; however, one-third of patients has no history of sinus disease in childhood, and SSS can occur in a normal and welldeveloped maxillary sinus.…”

“…and has also been reported in up to 1% of patients with Graves ophthalmopathy after orbital decompression. [3] However, SSS is not well known among general radiologists. [11] e aim of this report was to alert the reader to the pathophysiology and imaging findings on SSS.…”