Original Article
Clinical features, diagnosis and treatment of silent sinus syndrome
Zaixing Wang, Yinyan Lai, Fenghong Chen, Jianbo Shi, Kejun Zuo
Published 2018-11-07
Cite as Chin J Otorhinolaryngol Head Neck Surg, 2018, 53(11): 820-824. DOI: 10.3760/cma.j.issn.1673-0860.2018.11.005
Abstract
ObjectiveTo explore the clinical features, diagnostic methods and therapeutic strategy of silent sinus syndrome (SSS).
MethodsA retrospective study was made on eight SSS patients treated during 2013-2016 in Longgang ENT Hospital and Otorhinolaryngology Hospital of the First Affiliated Hospital of SUN Yat-sen University. The following clinical data, including demographic data, symptoms, history of trauma and surgery, signs, imaging examination, endoscopic surgery and postoperative outcomes, were analyzed to summarize the diagnosis and treatment experiences.
ResultsEight SSS patients showed the following clinical features: the proportions of both sexes and sinus sides were 4 to 4; seven cases (7/8) were adult, with an average of (48.1±11.8)y; seven cases (7/8) had long history of trauma or surgery, with an average of (17.9±10.5)y; seven cases (7/8) cannot recall the exact course of SSS; six cases (6/8) had no nasal symptoms; eight cases (8/8) had unilateral ocular discomforts; eight cases (8/8) had signs of unilateral enophthalmos (2-5 mm), accompanied with hypoglobus; and by CT and MRI scanning, eight cases (8/8) showed the unilateral maxillary sinus outlet obstruction, sinus full opacification, sinus wall bony rarefaction, sinus wall contraction, sinus volume loss, and the ipsilateral orbital floor bowing descent and orbital volume increase. After treated by endoscopic sinus surgery and followed-up for one year, four cases were cured, and the other four improved; no intra- or post-operative complications occurred; and no individual need a two-stage orbital plastic reconstruction.
ConclusionsSSS often develops in the unilateral maxillary sinus of adult patient with long history of trauma or surgery, but the nasal symptoms and signs are silent. Diagnostic for SSS depends on characteristic ocular sign and sinus CT imaging. Endoscopic sinus surgery helps to improve ocular and nasal signs and promote orbital self-reconstruction.
Key words:
Silent sinus syndrome; Enophthalmos; Paranasal sinuses; Natural orifice endoscopic surgery
Contributor Information
Zaixing Wang
Shenzhen Key Laboratory of ENT, Institute of ENT &
Longgang ENT Hospital, Shenzhen 518172, China
Yinyan Lai
Otorhinolaryngology Hospital and Institute of the First Affiliated Hospital of SUN Yat-sen University, Guangzhou Key Laboratory of Otorhinolarygology, Guangzhou 510080, China
Fenghong Chen
Otorhinolaryngology Hospital and Institute of the First Affiliated Hospital of SUN Yat-sen University, Guangzhou Key Laboratory of Otorhinolarygology, Guangzhou 510080, China
Jianbo Shi
Otorhinolaryngology Hospital and Institute of the First Affiliated Hospital of SUN Yat-sen University, Guangzhou Key Laboratory of Otorhinolarygology, Guangzhou 510080, China
Kejun Zuo
Otorhinolaryngology Hospital and Institute of the First Affiliated Hospital of SUN Yat-sen University, Guangzhou Key Laboratory of Otorhinolarygology, Guangzhou 510080, China
±s)；7例(7/8)患者有(17.9±10.5)年以前的外伤史或手术史；7例(7/8)患者无法准确回溯病程；6例(6/8)患者无鼻面部症状；8例(8/8)患者有单侧眼部不适；8例(8/8)患者有单侧眼球内陷(2～5 mm)或眼球下移；8例(8/8)患者CT、MRI检查发现单侧上颌窦口阻塞，窦内充满软组织密度影，窦壁骨质稀疏，窦壁内陷，窦腔容积缩小，同侧眶底壁弓形下移，眶内容积增加。经鼻内镜鼻窦开放手术治疗后1年随访，4例患者治愈，另4例好转；术中、术后无手术并发症，亦无需行二期眼眶整复术的患者。
