The Silent Sinus Syndrome: A Collaborative Approach between Rhinologists and Oculoplastics- Case Report and Literature Review

The Silent Sinus Syndrome (SSS) is a rare phenomenon originally described in 1964 by Montgomery, which often occurs unilaterally in the maxillary sinus with opacification and collapse. It is characterized by ipsilateral enophthalmos and hypoglobus or mistakenly as an exophthalmos of the contralateral eye. The pathophysiology is caused by obstruction of the ostiomeatal complex with subsequent maxillary sinus hypoventilation and development of negative intra-sinus pressure resulting in bony changes and sinus collapse. Radiographic evaluation by the mean of CT scan orbits and paranasal sinuses as well as nasal endoscopic examination are mandatory in diagnosing such cases. Treating such cases require a collaborative multidisciplinary approach to ensure the best possible results. In this case report, we discuss this rare phenomenon in terms of clinical presentation, clinical and radiological evaluation and conclude with the optimal treatment approach.