Audemard D, Galipienzo V, Marck E, Girard B, Romieu-Louvety A, Gaches F, Dupeyron G
CHU Nîmes, Hôpital G. Doumergue, 5, rue Hoche, 30029 Nîmes, France.
J Fr Ophtalmol. 2002 Mar;25(3):266-9.
The causes of spontaneous enophthalmos, without trauma, surgical factors, or systemic illness, which can be found are rare. A particular entity called silent sinus syndrome in the Anglo-Saxon literature, which concerns the long-term effect of hypoventilation of the maxillary sinus responsible for an attraction of the sinus walls, resulting in sagging of the orbital floor, itself responsible for the enophthalmos.
We report the case about a 29-year-old woman, presenting a left-side spontaneous enophthalmos, with sinus-type pains for 2 months. The clinical examination revealed a horizontal diplopia when looking leftwards. Computed tomography showed a maxillary homolateral sinusitis with characteristic attraction of the sinus walls. The draining of the sinus collection by inferior endoscopic enlargement of the maxillary ostium led to pain resolution. The enophthalmos and diplopia were stabilized.
After eradicating the orbital causes of enophthalmos, the sinus causes were sought more precisely, the pauci-symptomatic causes such as the silent sinus syndrome. The recognition of this syndrome stopped the progression of enophthalmos by making the maxillary sinus permeable again. A surgical reconstruction of the orbital floor can be proposed in order to correct the motility of the eyes and esthetic considerations.
在无外伤、手术因素或全身性疾病的情况下，能发现的自发性眼球内陷病因罕见。在盎格鲁 - 撒克逊文献中有一种特殊的病症称为沉默性鼻窦综合征，它涉及上颌窦通气不足的长期影响，这种影响会导致鼻窦壁吸引，进而引起眶底下垂，而眶底下垂本身会导致眼球内陷。
我们报告了一例29岁女性病例，该患者出现左侧自发性眼球内陷，并伴有两个月的鼻窦型疼痛。临床检查发现向左看时出现水平性复视。计算机断层扫描显示同侧上颌窦炎，并伴有鼻窦壁的特征性吸引。通过鼻内镜下扩大上颌窦口引流鼻窦积液后，疼痛缓解。眼球内陷和复视得到稳定。
在排除眼球内陷的眼眶病因后，更精确地寻找鼻窦病因，如沉默性鼻窦综合征等症状较少的病因。对该综合征的认识通过使上颌窦再次通畅而阻止了眼球内陷的进展。为了纠正眼球运动和美观方面的考虑，可以建议进行眶底手术重建。
