[Secondary surgeries in eyelid and orbital surgery]

If eyelid and orbital surgery is very often particularly rewarding, it can also be deceiving. Moreover, a dysfunction can be added to the aesthetic result, leading to a secondary surgery. Secondary surgeries at the orbital level will mainly relate to problems of volume (container - content), whereas at the eyelid level, it will be problems of position that will be met. These eyelids wrong positionings result from an imbalance of dynamic forces that could have preexisted to the first surgery or is a consequence of that surgery. And it's the clinical trial that will be key, allowing the prevention of complications in the first surgery and that in secondary surgery will do for the diagnostic and will lead to the repairing operation. Several examples will be presented and discussed.

[Silent sinus syndrome. Clinical case]

CLINICAL CASE

A 53 year-old man presented with a progressive enophthalmos without any sinus or nasal symptoms. There was no history of a trauma. The ophthalmology examination showed enophtalmos and hypoglobus. The computerized tomography (CT) showed a collapsed maxillary and frontal sinus and a lateral deviation of the nasal septum that led us to the diagnosis.

DISCUSSION

The clinical features of silent sinus syndrome are described, as well as the need to distinguish it from maxillary sinusitis.