Surgical dissection of the maxillary sinus mucosal lining is known to cause autoobliteration by bone formation. In most cases, it is diagnosed clinically, however, using the characteristic imaging features including maxillary sinus outlet obstruction, sinus opacification, and sinus volume loss caused by inward retraction of the sinus walls. The silent sinus syndrome is a form of chronic maxillary. The silent sinus syndrome sss involves painless facial asymmetry and enophthalmos, which is the result of chronic maxillary sinus atelectasis. Silent sinus syndrome is characterised by adultonset progressive enophthalmos due to collapse of some or all of the maxillary sinus walls. Postoperative outcomes were assessed, and statistical. Silent sinus syndrome is a rare clinical entity typically characterized by spontaneous and progressive enophthalmos and hypoglobus caused by an alteration of the normal orbital architecture and function from maxillary collapse in the setting of the chronic maxillary sinus hypoventilation. The clinical picture was inferior displacement of orbital floor without recent history of orbital. Silent sinus syndrome is a rare condition that can pose a diagnostic challenge. Silent sinus syndrome sss is a rare disorder with protean manifestations.
You are not alone, and many people have symptoms like you, either dental gingivitisgum disease, cavities, bad breath halitosis, toothache, dental sensitivity, pain. Silent sinus syndrome vs droopy eyelid thanks for your photo and interesting question. 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. The silent sinus syndrome sss is a rare cause of diplopia and facial asymmetry. The patient often presents with a droopy eyelid and a deep superior sulcus. The diagnosis based on clinical features and data of computed. Basically, the doctor i went to today said i do need sinus surgery, sooner rather than later. Silent sinus syndrome results from obstructed maxillary sinus drainage resulting in negative pressure and sinus wall collapse. The visual sign of silent sinus syndrome is the asymmetry of the face and the asymmetry of face may lead to many other problems like diplopia.
There was no deviation of the nasal septum and other paranasal sinuses were normally pneumatised. Spontaneous enophthalmos and hypoglobus, in the absence of other symptoms and unrelated to trauma or surgery, may be alarming to both physician and patient. Before you allow the doctor who diagnosed you to perform surgery, i would strongly recommend you get a second opinion from a doctor at a teaching hospital who specializes in treating these sorts. 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. The silent sinus syndrome sss is a rare condition that causes facial asymmetry, unilateral enophthalmos and diplopia.
A 27yearold man presented with a chief complaint of right eye enophthalmos. Rare radiological feature in silent sinus syndrome jama. Patients with the silent sinus syndrome seem to develop enophthalmos differently from those with mucoceles or active sinus infections. Silent sinus syndrome an acquired condition and the essential role of otorhinolaryngologist consultation. Diagnosis and management of silent sinus syndrome s. Imploding antrum or silent sinus syndrome following naso. It can cause painless facial asymmetry, diplopia and enophthalmos. Diplopia is seen in about 28 to 65% of cases regarding silent sinus syndrome. Radiographic findings include ipsilateral maxillary sinus opacification, lateralization of the uncinate and middle turbinate, and infundibular occlusion. Imaging spectrum of cavernous sinus lesions with histopathologic. Silent sinus syndrome without opacification of ipsilateral. However, in a small number of patients, trauma to the lateral nasal wall and ostiomeatal complex may be the cause, e.
It is believed that the condition is often undiagnosed or misdiagnosed. It was not until 30 years later, however, that the term silent sinus syndrome was attributed to this phenomenon. In a few rare cases of acute or chronic rhinitis, usually in the presence of a deviated nasal septum, the inflammation of the nasal mucosa can obstruct the nasal ostium. The authors report an unusual case revealed by mild dental. Although the underlying maxillary sinus pathology is silent. The authors describe the clinicopathologic features of a benign syndrome silent sinus syndrome with this constellation of features and discuss the possible pathophysiology. The onset of symptoms is usually slightly progressive but can be brisk due to sudden collapse of the. Traditionally, correction of the enophthalmos involved reconstruction of the orbital floor, which was performed simultaneously with sinus. Usually the diagnosis is suspected clinically, and it can be confirmed radiologically by characteristic imaging features that include maxillary sinus outlet obstruction, sinus. The lateral and medial walls merge inferiorly with each other at the superior margin of cranial nerve v2 2. Hi, i am a general surgeon am not well versed with ent diseases but as of my knowledge silent sinus syndrome is a very rare diagnosis with a very few reported cases.
Silent sinus syndrome sss is a rare disease characterized by spontaneous enophthalmos and hypoglobus secondary to collapse of the orbital floor in patients with asymptomatic maxillary sinusitis. It is secondary to chronic maxillary sinus atelectasis. The condition is quite uncommon and usually causes no pain when it occurs. The patient may present with unilateral ptosis or retraction.
Clinical features and outcomes of posttraumatic silent. The typical patient with silent sinus syndrome is an adult in the third. Natural cure for silent sinus syndrome and alternative. This case illustrates the acquired nature of this disorder. Such anatomic modifications occur over time, and therefore it is possible to encounter different stages of the. Is this silent sinus syndrome or do i just have droopy. The silent sinus syndrome, also known as imploding antrum and chronic maxillary sinus atelectasis, consists of findings of painless enophthalmos and inward retraction of the ipsilateral maxillary sinus walls on imaging studies 1, 2. The diagnosis of sss is confirmed by ct scans of the nose and paranasal sinuses which characteristically show maxillary sinus opacification and collapse with inferior bowing. Diagnosis and management of silent sinus syndrome american.
Silent sinus syndrome is a spontaneous, asymptomatic collapse of the maxillary sinus and orbital floor associated with negative sinus pressures. The caudal portion fragments to merge with the atrial myocardium. Silent sinus syndrome is a clinical entity with the constellation of progressive enophthalmos and hypoglobus due to gradual collapse of the orbital floor with opacification of the maxillary sinus, in the presence of subclinical maxillary sinusitis. Sick sinus syndrome may also be accompanied by intraatrial. P333 silent sinus syndrome in children case report. This syndrome was first described in 1964 by montgomery, but it was named silent sinus syndrome in 1994 by soparkar et al. Although the diagnosis is usually suspected clinically, it is confirmed radiologically by characteristic imaging features that include maxillary sinus outlet obstruction. The term sick sinus syndrome is applied to a clinical syn drome to. Clinical features and management strategies were recorded. Sick sinus syndrome may also be accompanied by intra atrial. It is difficult to determine a diagnosis from just one photo, but your orbital asymmetry could be a result of several conditions. Silent sinus syndrome or chronic maxillary sinus atelectasis is a rare condition that can pose a diagnostic challenge, as the medical history is often noncontributory. Silent sinus syndrome is defined as a spontaneous and progressive enophthalmos and hypoglobus with hypoplasia of the maxillary sinus and resorption of the orbital floor.
Can nasal irrigation cure silent sinus syndromesss. Hypoplasia of maxillary sinus caused by its longterm hypoventilation due to anatomical changes in osteomeatal complex. The silent sinus syndrome consists of painless facial asymmetry characterized by unilateral enophthalmos. Based on imaging findings a diagnosis of silent sinus syndrome was arrived at. He said we need to find out what is inside that sinus. Most cases of sick sinus syndrome are idiopathic, and the cause can be multifactorial table 1. Silent sinus syndrome definition silent sinus syndrome is a spontaneous, asymptomatic collapse of the largest paranasal sinus maxillary sinus and orbital floor linked with negative sinus pressure. It is thought to be secondary to chronic maxillary sinus atelectasis cma with reabsorbed bone and subsequent displacement of the orbital floor. Reabsorbed bone with displacement of the orbital floor is a constant finding. Sss is caused because of negative pressure causing collapse of sinus it may be be.
Silent sinus syndrome is spontaneous enophthalmos and hypoglobus associated with a small, ipsilateral maxillary sinus. Silent sinus syndrome sss is known to be a rare clinical condition, characterized by spontaneous and progressive enophthalmos and. The silent sinus syndrome refers to the collapse of the orbital floor and maxillary sinus which can cause changes in facial appearance. Patients typically present with unilateral painless enophthalmos and hypoglobus progressing over a period of several months. Posted by carolyn under silent sinus syndrome, health 50 comments. A 36yearold male was referred by his otolaryngologist to our oculoplastics clinic for evaluation of a sunken left. Although the diagnosis is usually suspected clinically, it is confirmed radiologically by characteristic imaging features that include maxillary sinus outlet obstruction, sinus opacification, and sinus volume loss.
Ocular motility limitation also occur and sometimes reported along with hypo globus. Silent sinus syndrome is an acquired condition that occurs in adults with unilateral, progressive, spontaneous enophthalmos and hypoglobus secondary to maxillary sinus hypoventilation caused by blockage of the ostiomeatal complex. The silent sinus syndrome consists of painless facial asymmetry and enophthalmos caused by chronic maxillary sinus atelectasis. This process can eventually lead to prolapse of the orbital contents, enophthalmos. Introduction the maxillary sinus is present at birth, undergoing further expansion with age. Sinus node and atrial arrhythmias circulation aha journals. Axial bone window the right maxillary antrum is volume depleted and opacified consistent with silent sinus syndrome. Silent sinus syndrome sss is an acquired unilateral maxillary atelectasis with complete or partial opacification of the sinus associated with enophtalmos and hypoglobus. Silent sinus syndrome sss is known as a rare clinical condition, characterized by spontaneous and progressive enophthalmos and hypoglobus associated with atelectasis of the maxillary sinus and alteration of the orbital floor.
It is commonly attributed to a sinus atelectasis secondary to ostiomeatal obstruction. To identify demographic features and clinical outcomes associated with posttraumatic silent sinus syndrome. The first case of maxillary sinus opacification and atelectasis was reported by montgomery in 1964. Silent sinus syndrome or chronic maxillary sinus atelectasis characterised by asymptomatic hypoplasia of maxillary sinus, progressive enophthalmos, facial asymmetry. Usually the diagnosis is suspected clinically, and it can be confirmed radiologically by characteristic imaging features that include. Negative sinus pressure and normal predisease imaging in. Silent sinus syndrome is a rare disorder, but it is probably underdiagnosed because of a lack of recognition 1. An absence of familiarity with ambiguous and atypical presentations. One such disease process, silent sinus syndrome, is a progressive condition in which maxillary sinus pathology causes inferior displacement of the orbital floor, resulting in enophthalmos and hypoglobus. At presentation, the maxillary os may be patent or occluded, and the sinus may be partially or completely opacified. Chiu silent sinus syndrome sss, is a rare disorder involving the maxillary antrum, characterized by an indolent course of subclinical maxillary sinusitis that leads to progressive contraction of the maxillary sinus. The silent sinus syndrome is a spontaneous unilateral maxillary atelectasis with complete or partial opacification of the sinus. Silent sinus syndrome, sss, unilateral enophthalmos, diplopia, chronic maxillary sinus atelectasis, displacement of the orbital floor, functional endoscopic sinus surgery 1.
Diagnosis and treatment of sick sinus syndrome american. Silent sinus syndrome is a very rare condition that is usually caused by some type of physical trauma or one of a handful of rare u deploying diseases. Silent sinus syndrome usually presents in the 3 rd to 5 th decade, without a gender predilection. Treatment of sick sinus syndrome includes removing extrinsic factors, when possible, and pacemaker placement. Silent sinus syndrome sss is known to be a rare clinical condition, characterized by spontaneous and progressive enophthalmos and hypoglobus associated with atelectasis of the maxillary sinus and alteration of the orbital floor. He had no visual symptoms and detailed ophthalmic examination showed a rightsided enophthalmos with hypoglobus, giving a sunken sulcus appearance to the right upper lid.
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