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Imaging in Rhinology
Published in R James A England, Eamon Shamil, Rajeev Mathew, Manohar Bance, Pavol Surda, Jemy Jose, Omar Hilmi, Adam J Donne, Scott-Brown's Essential Otorhinolaryngology, 2022
Phillip Touska, Stephen Connor
Silent sinus syndrome is due to obstruction of the ostiomeatal complex with opacification of the sinus and retraction of the walls (as opposed to sinus hypoplasia where the walls are straight). There is a characteristic clinical presentation of hypoglobus.
Case 76
Published in Simon Lloyd, Manohar Bance, Jayesh Doshi, ENT Medicine and Surgery, 2018
Simon Lloyd, Manohar Bance, Jayesh Doshi
This is a coronal computed tomography (CT) image showing mucosal thickening in both the maxillary sinuses. The most striking feature is that there is asymmetry of the maxillary sinuses, with the right side being smaller than the left and the orbital floor is lower as a result. This raises the possibility of the silent sinus syndrome. This is a condition in which there is spontaneous collapse of the maxillary sinus and orbital floor due to negative pressure within the sinus.
Disorders of the Orbit
Published in John C Watkinson, Raymond W Clarke, Louise Jayne Clark, Adam J Donne, R James A England, Hisham M Mehanna, Gerald William McGarry, Sean Carrie, Basic Sciences Endocrine Surgery Rhinology, 2018
Nithin D. Adappa, James N. Palmer
Imploding maxillary sinus or silent sinus syndrome is believed to originate from obstruction of the osteomeatal complex of the paranasal sinuses leading to hypoventilation of the maxillary sinus. This enclosed cavity in certain settings is thought to undergo air resorption, thus creating a suction effect of subatmospheric pressure within the maxillary antrum.34-36 The development of a pressure vacuum within the sinus, in turn, results in the accumulation of mucous into the antrum, subclinical inflammation and eventual collapse of the maxillary sinus through attenuation of the maxillary bony side walls. The hallmark of the disease is lack of traditional chronic sinusitis symptoms. Instead patients present with enopthalmos, occasionally with double vision as well.
Silent sinus syndrome after rhinoplasty: a case report
Published in Case Reports in Plastic Surgery and Hand Surgery, 2020
Mert Ersan, Arda Özdemir, Serdar Mehmet Gültan
Although Silent Sinus Syndrome was described in two asymptomatic patients by Montgomery in 1964, the definition of these symptoms as a syndrome was made by Soparkar in 1994 [1,2]. As a result of obstruction of the osteomeatal complex, the maxillary sinus is hypoventilated and negative pressure is created within the sinus due to the gradual diffusion of intra-sinus gases into the capillary circulation [3]. The negative pressure arises from mucus and other secretions that progressively accumulate in the sinus and causes a gradual collapse in the orbital floor within weeks or months [3]. However, as it can be understood from the name of the syndrome, although the majority of patients have radiological sinus wall retraction and total or near-total opacification of the sinus; sinusitis and similar sinus pathologies are not observed [4,5]. Although the maxillary sinus is mostly affected in Silent Sinus Syndrome, other paranasal sinuses, including the frontal and ethmoid sinus, can be affected individually or combined fashion [2]. Silent Sinus Syndrome after rhinoplasty was first introduced by Eloy et al. in a patient with isolated maxillary sinus involvement. Regarding Silent Sinus Syndrome after rhinoplasty, to our knowledge, this case report is the second case in the literature; however it is the first case in which three paranasal sinuses are affected together [5].
Radiological findings of orbital blowout fractures: a review
Published in Orbit, 2021
Ma ReginaPaula Valencia, Hidetaka Miyazaki, Makoto Ito, Kunihiro Nishimura, Hirohiko Kakizaki, Yasuhiro Takahashi
Silent sinus syndrome is a rare entity characterized by spontaneous enophthalmos and hypoglobus caused by maxillary sinus atelectasis following downward displacement of the orbital floor.55 Obstruction of the natural ostium of the maxillary sinus by prolapsed orbital contents and fractured bone leads to negative pressure, resulting in implosion of the maxillary sinus.55 This is a late-onset complication after orbital blowout fractures and a previous study showed the mean duration after trauma was 6.34 years.56 There had been several reports of this syndrome after blunt craniofacial trauma.55,56
Nonhealing orbital floor fracture in a pediatric patient: A unique presentation of pseudo-silent sinus syndrome
Published in Orbit, 2018
Siwei Zhou, Katherine Duncan, S. Tonya Stefko
Silent sinus syndrome is a rare disease which has been argued by Brandt and Wright to be considered a subtype of chronic maxillary atelectasis.8 There have been over 160 reported cases, and the disease predominantly affects individuals between the ages of 30 and 50 (Soparkar’s original publication of 19 cases reported a mean age of 36 years, range 29–46 years1). Radiologically, it is described as enophthalmos and hypoglobus resulting from downward concavity of the orbital floor and inward retraction of other walls of the maxillary sinus.5,6