Bilateral silent sinus syndrome: A rare case and review of literature

Post-traumatic Sinus Syndrome, Proposal for a New Clinical Entity (CDR Syndrome) as Variant of the Silent Sinus Syndrome: Systematic Review and Case Series

The diagnostic criteria for silent sinus syndrome (SSS) are still controversial, especially for the post-traumatic/surgery cases that are, nowadays, excluded from the diagnosis of SSS because lacking of spontaneously. We present a systematic review of the last 10 years and our case series of SSS associated to previous trauma/surgery, proposing a new interpretation of SSS. In this work, following the PRISMA guide lines for systematic reviews, we collected 86 articles published on PubMed, Cochrane Library and Medline Plus since 2013 to 2023 about SSS. We divided them in six groups forming the structure of the review: (1) epidemiology, (2) clinical presentation, (3) imaging, (4) etiopathogenesis, (5) sss and craniofacial trauma and (6) treatment. We reported two explicative clinical cases: two men of 34 and 37 years old, involved in motorcycle accident in 2020 and 2014, respectively, and underwent surgery. They came back in 2023 referring diplopia documented by Hess-Lancaster test. CT-scan reported two clear cases of SSS. Basing on what is reported in literature, and basing on our experience, the post-traumatic/surgery SSS are more frequent than the idiopathic ones. Our proposal is to considered them as two individual entities. We propose to adopt the name of Post-traumatic sinus syndrome, or CDR syndrome (Catalfamo-De Rinaldis), for all cases that respect four specific diagnostic criteria reported into the text.

Bilateral maxillary silent sinus syndrome: A case report and literature review

Silent sinus syndrome refers to a spontaneous enophthalmos caused by maxillary sinus collapse without any symptomatic sinonasal illnesses. Its prevalence is almost entirely unilateral. The authors report a patient with a bilateral silent sinus syndrome managed successfully by middle meatal antrostomies. This case brings attention to recognizing bilateral silent sinus syndrome. Because of its bilateral involvement, the facial disfigurement might be recognized late due to the symmetrical presentation. This article highlights the pathophysiology and reports the detailed course of such a rare disease. The balloon dilatation is promising as a newly described treatment modality in a patient with silent sinus syndrome, although more long-term data on its outcome is needed.

Etiology, Early Diagnosis and Proper Treatment of Silent Sinus Syndrome Based on Review of the Literature and Own Experience

PURPOSE

The authors' aim was to review the literature in terms of the etiology of the syndrome, the frequency of Silent Sinus Syndrome (SSS) and surgical procedure, as well as to present their own experience.

METHODS

The authors used PubMed, Medline, and Science Direct websites to find and review the most significant papers related to SSS. The case reports of SSS published between 2010 and 2020 were reviewed. A retrospective case review of 8 patients with SSS treated at the authors' departments was done.

RESULTS

The silent sinus syndrome has been reported in both children and adults. It is relatively rare and should be differentiated from congenital sinus hypoplasia or atelectasis. It most often affects the maxillary sinus. SSS is usually diagnosed when facial asymmetry or vision problems occur. Late diagnosis requires endoscopic sinus surgery, involving orbital wall reconstruction. The etiology of the syndrome, including the role of bacterial flora found in the sinuses, is unclear.

CONCLUSION

Early diagnosis of SSS enables avoiding orbital complications and limits surgical intervention to endoscopic surgery. Further research into bacteriology may help to understand the pathophysiology of the silent sinus syndrome.

Surgical Advances in the Management of the Silent Sinus Syndrome: Our Experience and Review of the Literature

Silent sinus syndrome is a rare disorder characterized by ipsilateral enophthalmos and hypoglobus caused by collapse of the orbital floor in the presence of asymptomatic long-term maxillary sinusitis. The basic principles in the management are to address the diseased sinus and reconstruct the orbit concurrently or separately. Failure to accurately restore the orbit volume can have significant consequences on the patient. In this article, we provide an update on current practices and highlight our experience of using computer-assisted planning and patient-specific implant in managing this syndrome.

Natural progression of bilateral maxillary silent sinus syndrome: A metachronous case report

Silent sinus syndrome refers to a constellation of spontaneous and progressive enophthalmos and hypoglobus in the setting of asymptomatic ipsilateral maxillary sinus atelectasis. Although its exact etiopathogenesis is not completely understood, obstruction of the ostiomeatal complex appears to be the inciting event. Most of the reported cases of silent sinus syndrome involve one maxillary sinus. Only a handful of true bilateral silent sinus syndrome cases have been reported in the literature. The aim of this report is to present a case of metachronous bilateral maxillary silent sinus syndrome and its natural progression. Also included is a review of the literature on ethmoidal, frontal, and bilateral maxillary silent sinus syndrome.

Bilateral Silent Sinus (Imploding Antrum) Syndrome

Silent sinus syndrome, also termed imploding antrum syndrome, describes spontaneous enophthalmos arising from contracture of the maxillary sinus in the complete absence of any symptomatic sinonasal disease. The unusual nasal structure that probably causes the condition renders its occurrence almost exclusively unilateral. The authors describe a patient with left silent sinus syndrome, who presented 4 years later with right silent sinus syndrome; to the authors' knowledge, this is only the second case of bilateral sequential silent sinus syndrome. Each side was successfully managed with endoscopic antrostomy and secondary orbital floor repair.

Combined Single-Step Procedure for Correction of Silent Sinus Syndrome

Silent sinus syndrome (SSS) is a rare condition characterized by enophthalmos and hypoglobus that is generally not related to trauma or surgery. We present a 30-year-old man who noticed facial asymmetry during the previous month and was referred to our oculoplastic clinic. His examination revealed right hypoglobus and a 2-mm right enophthalmos. The diagnosis of right SSS was confirmed by orbital and paranasal computed tomography scan. The patient had no otolaryngological symptoms and visual acuity was normal bilaterally. He was treated surgically in a combined approach by a team of oculoplastic and otorhinolaryngology surgeons. Functional endoscopic sinus surgery included uncinectomy, maxillary antrostomy, and orbitotomy, with insertion of an orbital implant. This case demonstrates that a single-step surgery for correction of enophthalmos secondary to SSS is a viable option, leading to quick rehabilitation and excellent aesthetic results.