Chavez-Montoya Ramiro, Araujo-Ramírez Osvaldo, Castillo-López Irma Yolanda, Govea-Camacho Luis Humberto
Servicio de Otorrinolaringología, Cirugía de Cabeza y Cuello, Hospital de Especialidades, Centro Médico Nacional de Occidente Guadalajara, Jalisco, México.
Servicio de Otorrinolaringología, Cirugía de Cabeza y Cuello, Hospital de Especialidades, Centro Médico Nacional de Occidente Guadalajara, Jalisco, México.
Cir Cir. 2017 Nov-Dec;85(6):529-534. doi: 10.1016/j.circir.2016.08.005. Epub 2016 Oct 21.
Silent sinus or imploding antrum syndrome is a very rare condition, consisting of a usually asymptomatic spontaneous collapse of the sinus walls and floor of the orbit. It is associated with negative pressures, and when this occurs, it presents with manifestations such as enophthalmos, hypoglobus, and tilt flow orbital floor. As its incidence is very low, it is frequently missed as a diagnosis, and in fact there are currently fewer than 150 cases reported in the literature.
Three patients have been identified in our practice over a period of two years, with different symptoms that influenced the decision of the treatment modality, which were: watch and wait, endoscopic sinus surgery, or endoscopic sinus surgery plus orbitoplasty.
Despite being a rare entity, it stills catches the attention of the ENT, OMF surgery and Ophthalmologist. The diagnosis is mainly radiological, due to the late clinical manifestations and symptomatology. The treatment should be individualised and based on the symptoms and the individual decision of each patient, firstly by Functional Endoscopic sinus surgery, and once sinus permeability is restored, it may require augmentation surgery of the orbital floor, either with autologous bone implant, titanium or other material. It is important to be aware of this pathology, to know and to suspect it, avoiding misdiagnosis.
静息性窦或眼眶内陷综合征是一种非常罕见的病症，通常表现为鼻窦壁和眶底的无症状性自发性塌陷。它与负压有关，一旦发生，会出现眼球内陷、眼球下移和眶底倾斜等表现。由于其发病率极低，常常被漏诊，实际上目前文献报道的病例少于150例。
在两年时间里，我们诊所确诊了3例患者，他们具有不同症状，这些症状影响了治疗方式的选择，分别为：观察等待、内镜鼻窦手术或内镜鼻窦手术加眼眶成形术。
尽管这是一种罕见病症，但仍引起了耳鼻喉科、口腔颌面外科和眼科医生的关注。由于临床表现和症状出现较晚，诊断主要依靠影像学检查。治疗应个体化，基于症状和每位患者的个人决定，首先采用功能性内镜鼻窦手术，一旦恢复鼻窦通畅，可能需要用自体骨植入物、钛或其他材料进行眶底修复手术。认识这种病理状况、了解并怀疑它，避免误诊非常重要。
