title: [Imploding antrum syndrome: three cases with different management approaches].
abstract: BACKGROUND
  Silent sinus or imploding antrum syndrome is a very rare condition, consisting of a usually asymptomatic spontaneous collapse of the sinus walls and floor of the orbit. It is associated with negative pressures, and when this occurs, it presents with manifestations such as enophthalmos, hypoglobus, and tilt flow orbital floor. As its incidence is very low, it is frequently missed as a diagnosis, and in fact there are currently fewer than 150 cases reported in the literature.
  
  
  METHODS
  Three patients have been identified in our practice over a period of two years, with different symptoms that influenced the decision of the treatment modality, which were: watch and wait, endoscopic sinus surgery, or endoscopic sinus surgery plus orbitoplasty.
  
  
  CONCLUSIONS
  Despite being a rare entity, it stills catches the attention of the ENT, OMF surgery and Ophthalmologist. The diagnosis is mainly radiological, due to the late clinical manifestations and symptomatology. The treatment should be individualised and based on the symptoms and the individual decision of each patient, firstly by Functional Endoscopic sinus surgery, and once sinus permeability is restored, it may require augmentation surgery of the orbital floor, either with autologous bone implant, titanium or other material. It is important to be aware of this pathology, to know and to suspect it, avoiding misdiagnosis.
authors: Servicio de Otorrinolaringología, Cirugía de Cabeza y Cuello, Hospital de Especialidades, Centro Médico Nacional de Occidente Guadalajara, Jalisco, México.
authors: Ramiro
authors: R
authors: Chavez-Montoya
authors: Servicio de Otorrinolaringología, Cirugía de Cabeza y Cuello, Hospital de Especialidades, Centro Médico Nacional de Occidente Guadalajara, Jalisco, México. Electronic address: oaraujor@hotmail.com.
authors: Osvaldo
authors: O
authors: Araujo-Ramírez
authors: Servicio de Otorrinolaringología, Cirugía de Cabeza y Cuello, Hospital de Especialidades, Centro Médico Nacional de Occidente Guadalajara, Jalisco, México.
authors: Irma Yolanda
authors: IY
authors: Castillo-López
authors: Servicio de Otorrinolaringología, Cirugía de Cabeza y Cuello, Hospital de Especialidades, Centro Médico Nacional de Occidente Guadalajara, Jalisco, México.
authors: Luis Humberto
authors: LH
authors: Govea-Camacho
mesh_terms: D000328:Adult; D058070:Asymptomatic Diseases; D001860:Bone Plates; D004172:Diplopia / Q000209:etiology*; D004724:Endoscopy / Q000379:methods*; D015841:Enophthalmos / Q000209:etiology*; D005260:Female; D005593:Fracture Fixation, Internal / Q000379:methods*; D005598:Fractures, Spontaneous / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D006801:Humans; D008297:Male; D008443:Maxillary Sinus / Q000000981:diagnostic imaging / Q000473:pathology* / Q000601:surgery; D008875:Middle Aged; D009917:Orbital Fractures / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery; D010254:Paranasal Sinus Diseases / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology / Q000601:surgery; D011312:Pressure; D012189:Retrospective Studies; D013577:Syndrome; D014057:Tomography, X-Ray Computed; D057832:Watchful Waiting
keywords: Atelectasia crónica maxilar; Chronic maxillary atelectasis; Complejo osteomeatal; Enoftalmos; Enophthalmos; Hipoglobus; Hypoglobus; Ostiomeatal complex; Silent sinus syndrome; Síndrome de seno silente