title: Spontaneous silent sinus syndrome (imploding antrum syndrome): case series of 16 patients.
abstract: BACKGROUND
  Silent sinus syndrome (SSS) is a rare idiopathic collapse of the maxillary sinus and orbital floor. We present the second largest series of sixteen patients with SSS and describe their management.
  
  
  METHODS
  A cohort of 16 patients with spontaneous SSS between 1999 and 2009 were reviewed at the Royal National Throat Nose and Ear Hospital. All patients were initially referred from a postgraduate ophthalmic hospital, Moorfields Hospital.
  
  
  RESULTS
  Fourteen patients required endoscopic sinus surgery to re-establish maxillary sinus drainage and the remaining two settled with intranasal medical therapy consisting of steroids and decongestions. Follow- up ranged from 6 months to 4 years with a mean of 2.6 years. An improvement in enophthalmos and was seen in all surgically treated patients with a mean improvement of 2.2mm and range 0.5-4mm.
  
  
  CONCLUSIONS
  SSS arises from congestion of the ostiomeatal complex resulting in negative pressure within the maxillary sinus and a gradual implosion of the antral cavity. Endoscopic sinus surgery successfully re-establishes maxillary aeration in our series and leads to clinical and aesthetic improvement in the degree of enophthalmos and has avoided the need for orbital floor repair in all but two cases.
authors.affiliation: Royal National Throat Nose and Ear Hospital, London, UK. Humerababar1@aol.com
authors.forename: H
authors.initials: H
authors.lastname: Babar-Craig
authors.forename: H
authors.initials: H
authors.lastname: Kayhanian
authors.forename: D J
authors.initials: DJ
authors.lastname: De Silva
authors.forename: G E
authors.initials: GE
authors.lastname: Rose
authors.forename: V J
authors.initials: VJ
authors.lastname: Lund
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D004724:Endoscopy; D015841:Enophthalmos / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D008443:Maxillary Sinus; D008875:Middle Aged; D009916:Orbital Diseases / Q000473:pathology / Q000601:surgery*; D010254:Paranasal Sinus Diseases / Q000000981:diagnostic imaging / Q000601:surgery*; D013577:Syndrome; D014057:Tomography, X-Ray Computed; D055815:Young Adult