Presentation
Facial asymmetry.
Patient Data
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 repeated osteolysis).
CT features of silent sinus syndrome are:
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