Zhou Siwei, Duncan Katherine, Stefko S Tonya
a Department of Ophthalmology , University of Pittsburgh Medical Center , Pittsburgh , Pennsylvania , USA.
Orbit. 2018 Oct;37(5):375-377. doi: 10.1080/01676830.2017.1423347. Epub 2018 Jan 10.
Silent sinus syndrome was first described as spontaneous enophthalmos and hypoglobus associated with subclinical maxillary sinusitis without prior trauma or surgery. This clinical entity has later been described after trauma in which damage to the ostiomeatal complex leads to atelectasis of the maxillary sinus. We report a case of a 14-year-old boy who presented 4 years after sustaining a non-operative orbital floor fracture with enophthalmos and transient diplopia. Computed tomography (CT) demonstrated enlargement in size of the original orbital floor fracture and bilateral maxillary sinus disease. Bilateral chronic sinusitis suggested an anatomical predisposition to sinusitis unrelated to the prior trauma. The authors propose that, in this case, negative pressure in the maxillary sinus and chronic inflammation led to bone resorption and failure of the orbital fracture to heal. This differs from prior reports of silent sinus syndrome in that there was complete resorption of bone of the orbital floor and no decrease in volume of the maxillary sinus given the open communication of the sinus and the orbit, making this a unique presentation of pseudo-silent sinus syndrome in a pediatric patient.
寂静性窦综合征最初被描述为与无既往创伤或手术史的亚临床上颌窦炎相关的自发性眼球内陷和眼球下移。这种临床病症后来在创伤后被描述，其中窦口鼻道复合体受损导致上颌窦肺不张。我们报告一例14岁男孩的病例，他在非手术性眶底骨折4年后出现眼球内陷和短暂性复视。计算机断层扫描（CT）显示原眶底骨折增大以及双侧上颌窦病变。双侧慢性鼻窦炎提示存在与既往创伤无关的鼻窦炎解剖易感性。作者提出，在该病例中，上颌窦内的负压和慢性炎症导致骨吸收以及眶骨折愈合失败。这与既往寂静性窦综合征的报道不同，因为眶底骨质完全吸收且由于窦与眶的开放连通上颌窦容积未减小，这使得该病例成为小儿患者假性寂静性窦综合征的独特表现。
