title: Nonsurgical management of silent sinus syndrome with hyaluronic acid gel.
abstract: A 44-year-old woman was referred with 3 mm of left enophthalmos and a deep superior sulcus. She was diagnosed 6 months earlier with silent sinus syndrome and had undergone a left middle-meatal antrostomy with improvement of her hypoglobus but not of her enophthalmos and superior sulcus deformity. Two milliliters of Restylane SubQ (Q-Med AB, Uppsala, Sweden) was injected as a single bolus in the intraconal and extraconal posterior orbit via a standard transcutaneous inferotemporal approach using a primed green 21-gauge needle. Immediate reduction of enophthalmos by approximately 2 mm and superior sulcus improvement were noted. This remained stable at 6 months. The symptoms and signs of silent sinus syndrome can be effectively corrected with this minimally invasive nonsurgical option. To our knowledge, the use of hyaluronic acid gel for the treatment of enophthalmos in silent sinus syndrome has not been previously reported.
authors.affiliation: Department of Ophthalmology, Metropolitan Hospital, Athens, Greece. jmavrikakis@yahoo.com
authors.forename: Ioannis
authors.initials: I
authors.lastname: Mavrikakis
authors.forename: Efstathios T
authors.initials: ET
authors.lastname: Detorakis
authors.forename: Ioannis
authors.initials: I
authors.lastname: Yiotakis
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Kandiloros
mesh_terms: D000276:Adjuvants, Immunologic / Q000627:therapeutic use*; D000328:Adult; D015841:Enophthalmos / Q000188:drug therapy* / Q000209:etiology; D005260:Female; D005782:Gels / Q000008:administration & dosage; D006801:Humans; D006820:Hyaluronic Acid / Q000031:analogs & derivatives* / Q000627:therapeutic use; D056965:Injections, Intraocular; D010254:Paranasal Sinus Diseases / Q000150:complications*; D016896:Treatment Outcome
chemical_list: D000276:Adjuvants, Immunologic; D005782:Gels; D006820:Hyaluronic Acid; C445361:Restylane