To review the surgical outcome of five cases of silent sinus syndrome (SSS) who were treated with simultaneous endoscopic antrostomy and orbital implant placement. Patients with SSS often present with cosmetic change to their facial appearance (enophthalmos, hypoglobus, deep upper lid sulcus). Design: Retrospective case series.
Chart review was performed for cases of SSS who were seen between 1995 and 2003 in two tertiary eye care centers. The age, affected side, presenting symptoms and duration, history of trauma, smoking, and chronic sinusitis, degree of enophthalmos and hypoglobus were recorded.
All patients had a satisfactory post-operative result with correction of the enophthalmos, hypoglobus, and deep upper lid crease deformity. There were no untoward effects such orbital implant infection, diplopia, vision loss or hematoma.
Simultaneous endoscopic antrostomy and orbital implant placement can achieve a satisfactory outcome in cases of SSS with significant enophthalmos and hypoglobus. Orbital implant placement carries minimal risks and should not be delayed only to potentially avoid infection, diplopia, or visual loss, as these events are unlikely.
[Show abstract][Hide abstract] ABSTRACT: The terms chronic maxillary atelectasis (CMA) and silent sinus syndrome (SSS) have been used to describe spontaneous enophthalmos in association with a contracted ipsilateral maxillary sinus. Despite the use of differing taxonomy, it appears that these two terms describe the same clinical entity. Nevertheless, many reports still discuss CMA and SSS in isolation or as distinct conditions.
A systematic review of all reported cases of CMA and SSS was performed (1964-2006). Case reports were excluded if they involved facial trauma, diagnosis of mucocele, or previous surgery. Eligible cases were reviewed and entered into a database. Data were evaluated based on literature of publication, reported diagnosis, demographics, ophthalmologic examination, results of imaging, and operative findings. Only complete data sets were included in an additional analysis whereby the diagnostic criteria for CMA and SSS were applied and the data sets were compared.
Of the 105 cases reviewed, 55 contained complete data sets. Twenty-seven of these cases met the diagnostic criteria for SSS, and 48 could be diagnosed as CMA, with 23 meeting the criteria for both conditions. Comparing the cases across diagnoses, the only difference observed was that of the presence of sinus-related symptoms, which by definition distinguishes CMA III from SSS.
The entity termed SSS fits within the staging classification of CMA. We propose abandoning the term SSS and recommend universal adoption of the CMA staging system, which uses nomenclature that more accurately portrays the pathophysiology and natural history of this condition.
American Journal of Rhinology 01/2008; 22(1):68-73. DOI:10.2500/ajr.2008.22.3118 · 1.36 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Silent sinus syndrome (SSS) is a quite rare clinical entity characterized by unilateral enophthalmos and hypoglobus secondary to thinning and inward bowing of the maxillary sinus roof in the absence of signs or symptoms of intrinsic sinonasal inflammatory disease. We present a case of a 16-year-old female with a 10-month history of facial asymmetry due to swelling of the left cheek and ptosis of the left eye with no other symptoms. Computed tomography scans and Water's x-ray revealed an opacified left maxillary antrum with characteristic features of SSS. The patient underwent surgery and a thick maxillary sinus mucocele was found and enucleated successfully during the operation. Six-month and 2-year follow-ups after surgical treatment revealed satisfactory results and there was no need for reconstruction of the orbital floor. Although patients with SSS often initially present to ophthalmologists, oral and maxillofacial surgeons and radiologists should be familiar with this phenomenon since most of these patients will be referred to dental hospitals for further treatment.
[Show abstract][Hide abstract] ABSTRACT: Silent sinus syndrome is a rare disorder affecting the maxillary sinus unilaterally, characterized by ipsilateral enophthalmos and hypoglobus. The treatment is surgical: the endoscopic approach represents the gold standard for the restoration of normal sinus aeration, but there is no consensus in the management of the enophthalmos. Most authors suggest a two stage procedure consisting of endoscopic sinus surgery initially and a delayed secondary operation for the restoration of the orbital floor. We present our experience with three cases treated with a single-stage procedure, focusing on the advantages of this one-step approach.
Journal of cranio-maxillo-facial surgery: official publication of the European Association for Cranio-Maxillo-Facial Surgery 09/2010; 38(6):469-72. DOI:10.1016/j.jcms.2009.12.003 · 2.93 Impact Factor
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