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 28,634 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Enophthalmos previously has been reported to be a rare complication of maxillary sinus mucoceles. We report three patients treated by the senior author (T.C.C.) over a 2-month period for enophthalmos or obvious deformity of the midface associated with complete opacification of the maxillary antrum. Most previous authors have stressed the role of chronic pressure necrosis or osteitis leading to bone destruction, with primary involvement of the orbital floor. No patients in this series had symptoms typical of maxillary sinus mucoceles. Two of our three patients presented with minimal symptoms of chronic infection. There was inward collapse of the anterior, superior, lateral, and medial walls of the maxillary sinus, with no radiographic or intraoperative confirmation of bone destruction. We speculate that this process may be the result of chronic maxillary hypoventilation with subsequent atelectasis of the antrum secondary to chronic negative pressure. All patients had obstruction at the osteomeatal complex and were treated by endoscopic enlargement of the natural maxillary ostium.
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PMID:Atelectasis of the maxillary sinus with enophthalmos and midface depression. 851 68

Over a period extending from January 1993 to December 1995, we treated 242 patients with 268 orbital floor fractures in our department. Surgical indications were broad and relied on clinical criteria (enophthalmos, diplopia, hypoesthesia) and/or CT analysis (bony collapse, extrusion of orbital contents, suspicion of muscular entrapment, dislocation of the infraorbital rim). Two years after surgery, 91% of the patients showed good results (absence of diplopia or severe enophthalmos). The analysis of these results points out that the degree of sequelar enophthamos was not only related to the degree of initial bony collapse but above all to the quality of the bony reconstruction. Sequelar diplopia was linked with the presence of a preoperative diplopia and its severity was a direct function of operative delay. Hypoesthesia in the infraorbital nerve territory was the most common sequela; some were postoperative complications. The type of material used for the restoration of the orbital floor was not involved in the development of these sequela. Our good results suggest that an interventionist attitude is warranted in these kind of fractures, the more so as the X-ray examinations often underestimate injuries.
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PMID:[Long-term outcome of surgically treated orbital floor fractures. Apropos of a series of 242 patients]. 984 60

Pure orbital blowout fracture first occurs at the weakest point of the orbital wall. Although the medial orbital wall theoretically should be involved more frequently than the orbital floor, the orbital floor has been reported as the most common site of pure orbital blowout fractures. A total of 82 orbits in 76 patients with pure orbital blowout fracture were evaluated with computed tomographic scans taken on all patients with any suspicious clinical evidence, including nasal fracture. Isolated medial wall fracture was most common (55 percent), followed by medial and inferior wall fracture (27 percent). The most common facial fracture associated with medial wall fracture was nasal fracture (51 percent), not inferior wall fracture (33 percent). This finding suggests that the force causing nasal fracture is an important causative factor of pure medial wall fracture as the buckling force from the medial orbital rim. Of patients with medial wall fractures, 25 percent had diplopia and 40 percent had enophthalmos. On plain radiographs, diagnostic signs were found in 79 percent of medial wall fractures and in 95 percent of inferior wall fractures. On computed tomographic scans, late enophthalmos was expected in 76 percent of medial wall fractures. Therefore, the medial orbital blowout fracture may be an important cause of late enophthalmos, because it has a high incidence of occurrence, a low diagnostic rate, and a high severity of defect. Among the causes of limitation of ocular motility, muscle traction of the connective septa and direct muscle injury were found frequently, but true incarceration of the muscle was extremely rare in all fractures. The medial and inferior orbital walls are clearly demarcated by the bony buttress, which is an important structure supporting these orbital walls. Its buttress was closely correlated with the fracture of these orbital walls. Most orbital blowout fractures without collapse of the bony buttress had a trapdoor fracture with or without small fragments of punched-out fracture.
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PMID:Pure orbital blowout fracture: new concepts and importance of medial orbital blowout fracture. 1045 47

Patients with silent sinus syndrome typically present for investigation of facial asymmetry. Unilateral, spontaneous enophthalmos and hypoglobus are the prominent findings at examination. Imaging of the orbit and sinuses characteristically show unilateral maxillary sinus opacification and collapse with inferior bowing of the orbital floor. It has been suggested that SSS is due to hypoventilation of the maxillary sinus secondary to ostial obstruction and sinus atelectasis with chronic negative pressure within the sinus. Treatment involves functional endoscopic sinus surgery for reestablishing a functional drainage passage, and a reconstructive procedure of the floor of the orbit for repairing the hypoglobus and cosmetic deformity. Ophthalmologists, otorhinolaryngologists, and radiologists must be familiarized with this relatively newly reported disease.
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PMID:The silent sinus syndrome. 1590 69

Silent sinus syndrome is a rare clinical entity typically characterized by spontaneous and progressive enophthalmos and hypoglobus caused by an alteration of the normal orbital architecture and function from maxillary collapse in the setting of the chronic maxillary sinus hypoventilation. The authors report an unusual case revealed by mild dental pain, present the imaging (before, during and after the development of the disease), discuss the different theories related to pathogenesis and comment the treatment.
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PMID:The silent sinus syndrome. 1648 57

We present the case of a progressive enophthalmos, 23 years after an orbital floor fracture treated conservatively. Imaging demonstrated orbital fat herniation into the pterygopalatine fossa and a collapse of the maxillary sinus walls. We hypothesise that some "silent sinus syndrome" might be caused by an aspiration phenomenon resulting from masticatory muscle movements.
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PMID:Silent sinus syndrome: a mechanical theory. 1675 27

Silent sinus syndrome is a rare clinical condition in which patients present with spontaneous enophthalmos and hypoglobus secondary to collapse of orbital floor due to chronic subclinical maxillary sinusitis. It is postulated that obstruction of the osteomeatal complex lead to negative antrum pressure which causes the maxillary sinus atelectasis.
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PMID:Silent sinus syndrome due to a maxillary mucocele. 1802 42

The silent sinus syndrome is a very infrequent pathology. It is described as an enophthalmos secondary to collapse and opacification of maxillary sinus without presenting sinus or nasal symptoms. Osteomeatal complex obstruction is the triggering physiopathologic factor. The clinical symptoms and imaging findings lead to the diagnosis. The treatment consists in restoring sinus ventilation and, if necessary, correcting the orbital floor. We report a case of a woman who was diagnosed and treated because of this entity in our hospital.
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PMID:[The silent sinus syndrome]. 1808 81

The silent sinus syndrome consists of painless facial asymmetry characterized by unilateral enophthalmos. Reabsorbed bone with displacement of the orbital floor is a constant finding. It is secondary to chronic maxillary sinus atelectasis. The onset of symptoms is usually slightly progressive but can be brisk due to sudden collapse of the orbital thin bony floor. The diagnosis is suggested by clinical findings including endonasal endoscopic examination and confirmed on the basis of computed tomography and magnetic resonance imaging. The restitution treatment of the silent sinus syndrome involves functional endoscopic sinus surgery and plastic reconstruction of the floor of the orbit via transconjunctival approach; an additional vestibular incision may be necessary to treat the malar region. Four cases of this rare and therefore relatively unknown disease are fully discussed.
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PMID:The silent sinus syndrome: diagnosis and surgical treatment. 1914 2

Silent sinus syndrome is a clinical entity with the constellation of progressive enophthalmos and hypoglobus due to gradual collapse of the orbital floor with opacification of the maxillary sinus, in the presence of subclinical maxillary sinusitis. It occurs secondary to maxillary sinus hypoventilation due to obstruction of the ostiomeatal unit. In this paper, a 35-year-old woman with a complaint of asymmetry in her left eye and denting of upper eyelid was reported. In the left eye, upper sulcus was deepened and there was 3-mm hypoglobus. There was no diplopia or restriction of eye movements in any gaze positions. Hertel exophthalmometry revealed a 4-mm enophthalmos on the left eye. Computed tomographic scan of the orbita and paranasal sinuses showed left maxillary sinusitis, air-fluid level, and collapse of left maxillary sinus walls. In addition, inferior bulging in the left orbital floor was also reported. The treatment was a 2-stage operation. In the first stage, she underwent endoscopic septoplasty plus left maxillary antrostomy, and in the second stage, she underwent a subciliary orbital floor repair of the iliac bone resulting in the improvement of the enophthalmos and her cosmetic appearance. Regarding this case, the literature is also reviewed in detail.
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PMID:Enophthalmos due to atelectasis of the maxillary sinus: silent sinus syndrome. 1988 40


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