Martínez-Capoccioni Gabriel, Varela-Martínez Ernesto, Martín-Martín Carlos
Servizo Galego de Saúde, Department of Otorhinolaryngology, University Hospital Complex of Santiago de Compostela, C/Choupana s/n. 15706, Santiago de Compostela, A Coruña, Spain.
Eur Arch Otorhinolaryngol. 2016 Oct;273(10):3183-8. doi: 10.1007/s00405-016-3965-x. Epub 2016 Mar 10.
The silent sinus syndrome (SSS) is a rare clinical entity characterized by painless spontaneous enophthalmos, hypoglobus, and facial deformities secondary to chronic maxillary sinus atelectasis. The aim of this study was to present an SSS diagnostic feature and evaluate the relationship between nasal septum deviation and maxillary sinus volume. A retrospective chart review of the clinical characteristics of 20 patients diagnosed with SSS between January 2013 and July 2014 were analyzed by the Department of Otorhinolaryngology of University Hospital Complex of Santiago de Compostela. 14 patients were females and six males. The mean age was 43 years (range 28-67 years). The right maxillary sinus was involved in 12 patients and the left maxillary sinus in eight patients. There was no statistical difference between gender and the presence of SSS. Maxillary sinus sizes were significantly smaller on the same side as the deviation (p < 0.01). 14 patients were treated with functional endoscopic sinus surgery (FESS) with maxillary antrostomy. We concluded that patients with SSS usually present with facial asymmetry, and the best approach to document and show all facial asymmetries for these patients are the frontal and craneo-caudal photographs. The present study demonstrates that, in adult patients, SSS generally presents a septal deviation to the affected maxillary sinus. We recommend performing a paranasal sinus CT scan when the patient has a deviated nasal septum, retraction of the malar eminence (evidenced from the viewpoint cranio-caudal facial) and hypoglobus. FESS performing postero-anterior uncinectomy and enlargement of the maxillary ostium is recommended to restore sinus pressure and prevent progression of the enophthalmos, hypoglobus and facial deformities.
静息性窦综合征（SSS）是一种罕见的临床病症，其特征为无痛性自发性眼球内陷、眼球低位以及继发于慢性上颌窦萎陷的面部畸形。本研究的目的是呈现SSS的诊断特征，并评估鼻中隔偏曲与上颌窦容积之间的关系。圣地亚哥德孔波斯特拉大学医院综合院区耳鼻喉科对2013年1月至2014年7月期间确诊为SSS的20例患者的临床特征进行了回顾性病历分析。其中女性14例，男性6例。平均年龄为43岁（范围28 - 67岁）。右侧上颌窦受累12例，左侧上颌窦受累8例。性别与SSS的存在之间无统计学差异。与偏曲同侧的上颌窦大小明显更小（p < 0.01）。14例患者接受了功能性鼻内镜鼻窦手术（FESS）并进行了上颌窦造口术。我们得出结论，SSS患者通常表现为面部不对称，对于这些患者，记录和显示所有面部不对称情况的最佳方法是额部和颅尾位照片。本研究表明，在成年患者中，SSS通常表现为患侧上颌窦的鼻中隔偏曲。我们建议，当患者出现鼻中隔偏曲、颧骨突出回缩（从颅尾位面部视角可见）和眼球低位时，进行鼻窦CT扫描。建议施行功能性鼻内镜鼻窦手术，进行前后位筛窦切除术并扩大上颌窦口，以恢复窦内压力，防止眼球内陷、眼球低位和面部畸形的进展。
