Chronic anterior sinus atelectasis due to middle meatus retraction.

INTRODUCTION

Chronic sinus atelectasis is a rare but classical etiology in maxillary sinusitis. Advanced forms induce orbital deformities. Here we report a case of chronic maxillary-ethmoidal-frontal sinus atelectasis, and detail treatment.

CASE REPORT: A 59 year-old man was referred for recurrent right periorbital pain with 2 years' progression, resistant to local corticosteroid treatment. Clinically, there was right middle turbinate lateralization and ipsilateral enophthalmos. CT showed filling of the right maxillary, anterior ethmoidal and frontal sinuses, with characteristic anterior chronic sinus atelectasis features: retraction of the thinned sinus walls, and decreased sinus volume, confirmed on 3D MRI. Functional ethmoidectomy resolved the obstruction caused by the atelectasis and relieved the patient's pain.

DISCUSSION: This was an original case of chronic sinus atelectasis implicating the middle meatus, with equal involvement of all three anterior sinuses. It highlights the importance of surgical treatment of all the involved sinuses, to stop progression and prevent recurrence.