Silent sinus syndrome: combined sinus surgery and orbital reconstruction – report of 15 cases

Abstract

Background: Silent sinus syndrome (SSS) is defined as spontaneous, painless enophthalmos, hypoglobus with orbital floor resorption and maxillary sinus collapse on the ipsilateral side. Different methods of orbital floor reconstruction have been proposed.

Aims/objectives: The purpose was to analyse the results of combined endoscopic sinus surgery (ESS) and reconstruction using orbital floor implant of 15 patients with SSS and to present recent histological findings.

Materials and methods: Retrospective case review of 15 patients with SSS treated in clinic between 2007 and 2017.

Results: Eleven women and four men presented with unilateral, spontaneous enophthalmos. Averaged duration of enophthalmos was 10.7 months. On affected side, mean enophthalmos was 2.6 mm and hypoglobus 2.7 mm. Computed tomography imaging (CT) imaging showed maxillary sinus opacification on the affected side in every case, and the orbital floor was displaced downwards in all cases. In total, 13 patients underwent simultaneous ESS and rebuilding of orbital floor with a titanium implant. Statistical analysis confirmed significant differences for pre- and postoperative measure of enophthalmos and hypoglobus.

Conclusion and significance: Implementation of titanium implants is the reliable method of reconstruction that allows good aesthetic result, shorter time of procedure with an excellent long-term outcome and satisfactory patient’s tolerance.

Chinese abstract

背景：静窦综合征（SSS）定义为自发的、无痛性眼球内陷、眼球下裂伴眶底吸收和同侧上颌窦塌陷。不同的眼底重建方法被提出。

目的：分析对15例SSS患者进行的鼻内镜手术（ESS）和用眶底植入重建的综合结果, 并介绍近期的组织学研究结果。

材料与方法：回顾性分析2007年至2017年期间临床治疗的15个SSS病例。

结果：11名女性和4名男性出现单侧自发眼球内陷。眼球内陷的平均持续时间为10.7个月。在病侧, 平均眼球内陷为2.6 mm, 眼球下陷为2.7 mm。CT显示每例患者上颌窦混浊, 眶底向下移位, 共13例患者同时接受ESS及钛植入体重建眶底。统计分析证实了眼球内陷和眼球下陷的术前和术后测量有显著差异。

结论与意义：施行钛植入体是一种可靠的重建方法, 具有良好的美学效果。其手术时间短, 远期疗效好, 患者耐受性好。

Keywords:

• Endoscopic sinus surgery
• enophthalmos
• orbital reconstruction
• Titan implant
• silent sinus syndrome

Disclosure statement

All authors declare no conflict of interest.