Silent sinus syndrome.
OBJECTIVE
Silent sinus syndrome is a clinical entity with the constellation of progressive enophthalmos and hypoglobus due to gradual collapse of the orbital floor with opacification of the maxillary sinus, in the presence of subclinical maxillary sinusitis.


RESULTS
It occurs secondary to maxillary sinus hypoventilation due to obstruction of the ostiomeatal unit. Correction of the problem is surgical. Surgery is endoscopic with reestablishment of maxillary aeration and drainage. The orbital repair can be staged. The endoscopic surgeon must be careful of the prolapsed orbital contents in to the maxillary sinus.


CONCLUSIONS
Silent sinus syndrome is rare and multiple findings are needed for the diagnosis. These include enophthalmos or hypoglobus in the absence of clinically evident sinonasal inflammatory disease. Treatment consists of correction of the maxillary sinus atelectasis and the orbital defects. There is evidence that a two-stage repair may eliminate the need to perform the orbital repair. Due to the lateral position of the uncinate, endoscopic maxillotomy needs to be done with care to avoid injury to the orbital contents.
Annino
Donald J
DJ
Division of Otolaryngology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts 02115, USA. dannino@partners.org
Goguen
Laura A
LA
D004724:Endoscopy; D015841:Enophthalmos / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008443:Maxillary Sinus; D015523:Maxillary Sinusitis / Q000150:complications* / Q000000981:diagnostic imaging / Q000503:physiopathology; D009916:Orbital Diseases / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D010254:Paranasal Sinus Diseases / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology / Q000601:surgery*; D012120:Respiration Disorders / Q000000981:diagnostic imaging / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D013577:Syndrome; D014057:Tomography, X-Ray Computed