Delayed presentation of silent sinus syndrome after orbital trauma.

OBJECTIVES

We describe the clinical presentation and management of a patient with a remote history of orbital trauma who presented with spontaneous right enophthalmos and radiographic findings consistent with silent sinus syndrome over 30 years after her initial orbital injury.

METHODS

The patient chart and imaging results were reviewed. A literature review of silent sinus syndrome and traumatic enophthalmos was performed.

RESULTS

Our patient had both clinical and radiographic findings consistent with silent sinus syndrome. Only 2 other cases of silent sinus syndrome after orbital trauma have been reported in the literature. The underlying anatomic pathology common to all cases is obstruction of the ostiomeatal complex with subsequent maxillary sinus hypoventilation and sinus collapse. Our patient underwent single stage repair with endoscopic maxillary antrostomy and had resolution of the mucosal disease at 6-month follow-up.

CONCLUSIONS

Posttraumatic cases of silent sinus syndrome are much less common than spontaneous cases but share similar pathophysiology and can be effectively treated using endoscopic techniques.