engleski

Management of Silent Sinus Syndrome in a pregnant woman

Silent sinus syndrome (SSS) is a rare disorder characterised by enophthalmos and hypoglobus, caused by ipsilateral maxillary sinus atelectasis. SSS typically affects younger patients between the third and fifth decade of life with no history of orbital trauma or chronic nasal and sinus disease. There is no dominance of gender or side. The pathophysiology of SSS is well described. Complete obstruction of ipsilateral ostiomeatal complex induces continued negative pressure within the sinus , which activates the osteoclasts and makes the sinus walls thinner , leading to their collapse. This then produces the descent of the orbital floor resulting in enophthalmos, hypoglobus and deepening of the superior palpebral sulcus. The diagnosis is clinical with CT confirmation. The treatment is surgical with simultaneous endoscopic sinus surgery and orbital floor reconstruction. We present a case of a 40-year-old pregnant woman in her 34- week of pregnancy with left eye enophthalmos, hypoglobus and severe deepening of the superior palpebral sulcus, but with no diplopia or symptoms of nasal obstruction. She was unaware of preexisting sinus disease and deny orbitofacial trauma. CT scan showed left maxillary sinus hypoplasia and complete opacification. On the basis of clinical and radiological findings, a diagnosis of SSS was made. Due to her late stage of pregnancy we decides to modulate our treatment with intranasal decongestives and antibiotics. Definite surgical treatment was postponed until the safe delivery of her child.

Silent sinus syndrome, case report, symptoms, pathophysiology, treatment

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