Silent sinus syndrome

Case contributed by Dr Azza Elgendy

Presentation

Facial asymmetry.

Patient Data

Age: 56 years
Gender: Male
CT

The right maxillary sinus is diminished in volume with total opacification. The orbital volume is relatively increased in size due to downward displacement of the orbital floor 

Case Discussion

There is total opacification of the maxillary antrum. All the walls of the maxillary sinus appear to be bowing toward the center. There is also relative increase of the orbital volume with resultant enophthalmos. The orbital floor is displaced inferiorly ( this can be demonstrated by a line passing through the two orbital floors). There is also increased retroantral fat. The uncinate process has deviated laterally causing more narrowing of the OMC .  There may be relative bone thickening (from the repeated osteolysis).

CT

  • diminished volume of maxillary sinus with total opacification
  • inward bowing of sinus walls
  • lateralization of the uncinate process with relative narrowing of the OMC
  • increased retroantral pad of fat
  • increased orbital volume with relative increase of the orbital fat 
  • downward displacement of the orbital floor
  • bone changes from the repeated inflammation
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Case information

rID: 27861
Case created: 23rd Feb 2014
Last edited: 8th Sep 2015
System: Head & Neck
Inclusion in quiz mode: Included

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