A rare complication of functional endoscopic sinus surgery: maxillary atelectasis-induced spontaneous enophthalmos.
BACKGROUND
The first case report of spontaneous enophthalmos due to maxillary atelectasis as a late complication of FESS is presented.


METHODS
Chart review of a 24-year-old male who developed a left progressive enophthalmos within three months post bilateral functional endoscopic sinus surgery.


RESULTS
The preoperative computed tomography showed a normal left maxillary sinus. The postoperative computed tomography revealed a left maxillary atelectasis with a descending orbital floor. The subject received revised endoscopic sinus surgery and his enophthalmos was stable without further progression after the operation.


CONCLUSIONS
This may have been caused by an ostium occlusion with retention of secretions inducing sinus inflammation, osteolytic activity, and osseous remodeling of the sinus walls. A negative pressure may develop. When the pressure gradient exceeds the sinus wall tension, maxillary atelectasis and enophthalmos occur. Prevention of this complication of FESS should include making a patent naso-antral window, minimizing mucosal trauma, and careful postoperative sinoscopic treatment. A "functional" sinus is the goal.
Wu
Chin-Lung
CL
Department of Otolaryngology-Head and Neck Surgery, National Taiwan University Hospital, No. 7 Chung-Shan South Road, Taipei, Taiwan.
Hsu
Ming-Che
MC
Liu
Chia-Ming
CM
D000328:Adult; D004724:Endoscopy / Q000009:adverse effects*; D015841:Enophthalmos / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D006801:Humans; D008297:Male; D015523:Maxillary Sinusitis / Q000000981:diagnostic imaging / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome