Silent Sinus Syndrome of the Frontal Sinus: A Case Report.

Silent sinus syndrome is a rare condition that typically affects the maxillary sinus, with only a few reported cases of frontal sinus involvement. Blockage of the sinus ostium leads to persistent hypoventilation, creating negative pressure and eventual sinus collapse. This report describes a previously undocumented case of facial asymmetry due to frontal silent sinus syndrome, following multiple childhood nasal injuries. A 23-year-old male presented with unilateral nasal obstruction, right-sided septal deviation and facial asymmetry. He sustained multiple childhood nasal injuries, requiring manipulation under anaesthetic of his nasal bones at four years old. Imaging reported symmetrical maxillary sinus volumes, with an opacified and collapsed left frontal sinus caused by obstruction of the sinus ostium, secondary to significant left-sided deviation of his bony nasal septum. Open septorhinoplasty was performed, with post-operative resolution of his cosmetic and functional nasal deformities. This report describes a case of frontal silent sinus syndrome causing ipsilateral hyperglobus and enophthalmos, successfully treated with open septorhinoplasty. Silent sinus syndrome rarely affects the frontal sinus and should be considered in asymptomatic patients with facial asymmetry. This advanced presentation highlights the importance of early recognition to prevent visual disturbance and proposes a perspective on disease progression.