The silent sinus syndrome: protean manifestations of a rare upper respiratory disorder revisited

Denisse E Guillen, Paulette M Pinargote, Juan C Guarderas, Denisse E Guillen, Paulette M Pinargote, Juan C Guarderas

Abstract

Silent Sinus Syndrome (SSS) is known to be a rare clinical condition, characterized by spontaneous and progressive enophthalmos and hypoglobus associated with atelectasis of the maxillary sinus and alteration of the orbital floor. Most of the patients with this syndrome present with ophthalmological complaints without any nasal sinus symptoms, and it typically has a painless course and slow development, ergo the term "silent." Here we present a case report of a patient with occasional coughing spells as the presenting symptom of Silent Sinus Syndrome, which has not been previously described in the literature. The CT scan findings suggested chronic rhinosinusitis. The radiological findings were suggestive of maxillary sinus hypoplasia, with evidence of maxillary sinus atelectasis. Awareness of this syndrome is important for specialists who work with nasal sinus disease, since its management is different than chronic rhinosinusits.

Figures

Figure 1
Figure 1
Examination reveals an asymmetrically smaller and completely opacified left maxillary sinus with left-sided periosteal thickening, as well as lateral bowing/bone remodeling of the uncinate process.
Figure 2
Figure 2
The left maxillary sinus is smaller and opacified. The middle meatus space is wide and the medial wall of the sinus is lateralized with contact with the lateral wall of the maxillary sinus.

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