de Dorlodot Clotilde, Collet Stephanie, Rombaux Philippe, Horoi Mihaela, Hassid Sergio, Eloy Philippe
ENT Department, Université Catholique de Louvain, Centre Hospitalier Universitaire UCL Namur, Av. Docteur Gaston Therasse 1, 5530, Yvoir, Belgium.
ENT Department, Cliniques Universitaires Saint-Luc, UCL, Av. Hippocrate 10, 1200, Bruxelles, Belgium.
Eur Arch Otorhinolaryngol. 2017 Sep;274(9):3367-3373. doi: 10.1007/s00405-017-4622-8. Epub 2017 Jun 1.
Chronic maxillary atelectasis (CMA) and silent sinus syndrome (SSS) are rare clinical entities characterized by an implosion of the maxillary sinus that may or may not be associated with sinonasal symptoms, and are complicated by ipsilateral enophthalmos. The objective of this article is to discuss the definitions, physiopathology, clinical and radiographic characteristics, and surgical management of these entities. We retrospectively reviewed 18 patients (7 women, 11 men, aged 12-70 years) diagnosed and treated in the ear, nose, and throat departments of four Belgian teaching hospitals between 2000 and 2015. Nine patients had a history of sinus disease. In all cases, a computed tomography scan showed downward displacement of the orbital floor, increased orbital volume, and maxillary sinus contraction. Five patients met the criteria for grade II CMA and 13 for grade III CMA. Four patients met the criteria for SSS. All patients underwent wide endoscopic middle maxillary antrostomy. There were no orbital complications and all patients experienced resolution or a dramatic reduction of their symptomatology. Only one patient asked for an orbital floor reconstruction to correct a persisting cosmetic deformity. Although CMA and SSS are usually regarded as different entities in the literature, we believe that they lie on the same clinical spectrum. Treatment for both conditions is similar, i.e., middle meatal antrostomy to halt or even reverse the pathological evolution and reconstruction of the orbital floor in the event of persistent cosmetic deformity.
慢性上颌窦肺不张（CMA）和沉默性窦综合征（SSS）是罕见的临床病症，其特征为上颌窦内陷，可能伴有或不伴有鼻窦症状，并伴有同侧眼球内陷。本文的目的是讨论这些病症的定义、生理病理学、临床和影像学特征以及手术治疗方法。我们回顾性分析了2000年至2015年间在比利时四家教学医院的耳鼻喉科诊断和治疗的18例患者（7名女性，11名男性，年龄12 - 70岁）。9例患者有鼻窦疾病史。所有病例的计算机断层扫描均显示眶底向下移位、眶容积增加和上颌窦收缩。5例患者符合II级CMA标准，13例符合III级CMA标准。4例患者符合SSS标准。所有患者均接受了广泛的内镜下中鼻道上颌窦造瘘术。无眼眶并发症，所有患者的症状均得到缓解或显著减轻。只有1例患者要求进行眶底重建以纠正持续存在的美容畸形。尽管在文献中CMA和SSS通常被视为不同的病症，但我们认为它们处于同一临床谱系。两种病症的治疗方法相似，即中鼻道造瘘术以阻止甚至逆转病理演变，以及在存在持续美容畸形的情况下进行眶底重建。
