title: Silent sinus syndrome: dynamic changes in the position of the orbital floor after restoration of normal sinus pressure.
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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Ear, Nose and Throat Department, The Canberra Hospital, Australian Capital Territory, New South Wales, Australia.
authors.forename: R
authors.initials: R
authors.lastname: Sivasubramaniam
authors.forename: R
authors.initials: R
authors.lastname: Sacks
authors.forename: M
authors.initials: M
authors.lastname: Thornton
mesh_terms: D000328:Adult; D002908:Chronic Disease; D004724:Endoscopy; D015841:Enophthalmos / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D015523:Maxillary Sinusitis / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D008875:Middle Aged; D009915:Orbit / Q000473:pathology*; D011312:Pressure; D011859:Radiography; D012086:Reoperation; D012189:Retrospective Studies; D013577:Syndrome; D016896:Treatment Outcome; D055815:Young Adult