Presentation
Facial asymmetry.
Patient Data
The left maxillary sinus is diminished in volume and totally opacified with obliteration of the left osteomeatal complex, inward bowing of the sinus walls and downward displacement of the orbital floor. Thickened sclerosed bony walls with a minor defect in the anterior wall are also noted suggesting chronic sinusitis.
Subtle bilateral ethmoid sinusitis and the mild rightward deviation of the nasal septum were also noted.
Case Discussion
The silent sinus syndrome is believed to be due to chronic sinusitis with negative pressure causing retraction of the sinus walls. Imaging features in CT include sinus opacification, lateral bowing of the medial wall of the maxillary sinus and the uncinate process, as well as the descent of the orbital floor. Silent sinus syndrome might be complicated by enophthalmos and hypoglobus.
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