Document Type
Head & Neck Imaging
Publication Title
Unveiling the Silent Specter: A Comprehensive Exploration of Silent Sinus Syndrome
Abstract
A 42-year-old individual presented to the outpatient clinic with subtle facial asymmetry noted over the past year, primarily characterized by a progressive, painless sinking of the right eye (enophthalmos). The patient reported a history of mild, intermittent nasal obstruction but no acute sinus infections, significant nasal discharge, or facial pain. Despite these mild symptoms, the patient expressed concern over the noticeable change in facial appearance and occasional double vision, which prompted a visit to the clinic.The patient described a gradual onset of the right eye appearing "sunken" without any preceding trauma, infection, or significant weight loss. Initially dismissed as a cosmetic irregularity, the condition slowly progressed, leading to mild diplopia, particularly when looking to the sides. Examination revealed unilateral enophthalmos of the right eye with no palpable mass or tenderness in the maxillofacial region. Nasal examination showed slight mucosal swelling but no polyps or signs of acute infection. Ophthalmologic evaluation confirmed mild enophthalmos without any significant restriction of eye movements, but Hess charting indicated slight impairment consistent with the patient's diplopia reports.A high-resolution computed tomography (CT) scan of the paranasal sinuses and orbit was ordered, revealing complete opacification and collapse of the right maxillary sinus, with inferior bowing of the orbital floor—features diagnostic of Silent Sinus Syndrome. No evidence of acute sinusitis or other sinonasal pathology was observed.The patient was referred to an otolaryngology specialist for further management. Functional endoscopic sinus surgery (FESS) was performed to restore normal maxillary sinus drainage and relieve the ostium obstruction. Concurrently, an ophthalmic surgeon conducted orbital floor reconstruction to address the enophthalmos and correct the facial asymmetry. The postoperative period was uneventful, and follow-up visits showed significant improvement in the patient's facial appearance and resolution of diplopia.
Publication Date
2024
Recommended Citation
BENNY, DEEPAK Dr; Das, Sudha Kiran Dr; and Poojary, Shwetha R. Dr, "Unveiling the Silent Specter: A Comprehensive Exploration of Silent Sinus Syndrome" (2024). Radiology Teaching Files. 26.
https://rescon.jssuni.edu.in/radiologyteachingfiles/26
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