Skip to main content Accessibility help
×
Home

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

  • R Sivasubramaniam (a1), R Sacks (a2) and M Thornton (a3)

Abstract

Background:

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.

    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

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

      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

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

      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

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

Copyright

Corresponding author

Address for correspondence: A/Prof R Sacks, ENT Centre, Suite 12 The Madison, 25–29 Hunter Street, Hornsby, NSW, Australia2077 Fax: + 61 2 94824695 E-mail: rsacks@commander360.com

Footnotes

Hide All

Presented orally at the Australian Society of Otolaryngology Head and Neck Surgery Annual Scientific Conference, 29 March 2010, Sydney, New South Wales, Australia

Footnotes

References

Hide All
1Montgomery, WW. Mucocele of the maxillary sinus causing enophthalmos. Eye Ear Nose Throat Mon 1964;43:41–4
2Soparker, CN, Patrinely, JR, Cuaycong, MJ, Dailey, RA, Kersten, RC, Rubin, PA et al. The silent sinus syndrome: a cause of spontaneous enophthalmos. Ophthalmology 1994;101:772–8
3Kass, ES, Salman, S, Montgomery, W. Manometric study of complete ostial occlusion in chronic maxillary atelectasis. Laryngoscope 1996;106:1255–8
4Davidson, JK, Soparkar, CN, Williams, JB, Patrinely, JR. Negative sinus pressure and normal predisease imaging in silent sinus syndrome. Arch Ophthalmol 1999;117:1653–4
5Kass, ES. The diagnosis and treatment of chronic maxillary atelectasis in adults and children. Curr Opin Otolaryngol Head Neck Surg 1999;7:3945
6Annino, DJ Jr, Goguen, LA. Silent sinus syndrome. Curr Opin Otolaryngol Head Neck Surg 2008;16:22–5
7Brandt, MG, Wright, ED. The silent sinus syndrome is a form of chronic maxillary atelectasis: a systematic review of all reported cases. Am J Rhinol 2008;22:6873
8Dailey, RA, Cohen, JL. Surgical repair of the silent sinus syndrome. Ophthal Plast Reconstr Surg 1995;11:261–8
9Vander Meer, JB, Harris, G, Toohill, RJ, Smith, TL. The silent sinus syndrome: a case series and literature review. Laryngoscope 2001;111:975–8
10Thomas, RD, Graham, SM, Carter, KD, Nerad, JA. Management of the orbital floor in silent sinus syndrome. Am J Rhinol 2003;17:97100
11Wan, MK, Francis, IC, Carter, PR, Griffits, R, van Rooijen, ML, Coroneo, MT. The spectrum of presentation of silent sinus syndrome. J Neuroophthalmol 2000;20:207–12
12Numa, WA, Desai, U, Gold, DR, Heher, KL, Annino, DJ. Silent sinus syndrome: a case presentation and comprehensive review of all 84 reported cases. Ann Otol Rhinol Laryngol 2005;114:688–94
13Schraf, KE, Lawson, W, Shapiro, JM, Gannon, PJ. Pressure measurements in the normal and occluded rabbit maxillary sinus. Laryngoscope 1995;105:570–4
14Hunt, SM, Tami, TA. Sinusitis-induced enopthalmos: the silent sinus syndrome. Ear Nose Throat J 2000;79:578–84

Keywords

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed