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The Silent Sinus Syndrome

Clinical and Radiographic Findings

¹ Department of Radiology, University of Utah, 1A71 Medical Ctr., 50 N. Medical Dr., Salt Lake City, UT 84132.
² Department of Otolaryngology, University of Utah, School of Medicine, Salt Lake City, UT 84132.

View larger version (66K): [in a new window]   Fig. 1A. —Artist's rendition of silent sinus syndrome. Drawing shows typical facial asymmetry seen in silent sinus syndrome. Right globe is displaced downward (hypoglobus) with associated upper-lid retraction and deepening of upper-lid sulcus.

View larger version (36K): [in a new window]   Fig. 1B. —Artist's rendition of silent sinus syndrome. Drawing shows appearance of sinus in silent sinus syndrome. Uncinate process and medial sinus wall are retracted laterally with associated enlargement of medial meatus (asterisk). Orbital floor is retracted into sinus lumen (arrows), which increases orbital volume.

View larger version (116K): [in a new window]   Fig. 2A. —44-year-old man with 18-month history of painless, sagging right eye. Unenhanced CT image in coronal plane reveals fully developed opacified right maxillary sinus. Uncinate process is apposed to inferomedial orbital floor, occluding maxillary sinus infundibulum (arrow). Associated lateral retraction of medial sinus wall and middle turbinate with enlargement of middle meatus (asterisk) can be seen. Orbital floor is retracted into sinus lumen (arrowhead).

View larger version (125K): [in a new window]   Fig. 3A. —39-year-old man with 2-month history of diplopia. T2-weighted MR image obtained in coronal plane using fat-saturation technique shows opacified fully developed right maxillary sinus with retraction of orbital floor (arrowhead) into sinus lumen. Position of left uncinate process (U) is normal. Right uncinate process is apposed to inferomedial orbital floor, occluding maxillary sinus infundibulum (arrow). Medial sinus wall and middle turbinate are laterally retracted, causing enlargement of middle meatus (asterisk).

View larger version (159K): [in a new window]   Fig. 2B. —44-year-old man with 18-month history of painless, sagging right eye. CT image obtained in coronal plane posterior to A shows posterior wall of affected right maxillary sinus retracted into sinus lumen (arrow).

View larger version (99K): [in a new window]   Fig. 2C. —44-year-old man with 18-month history of painless, sagging right eye. CT image obtained in axial plane shows retraction of anterior wall (arrowhead), posterior wall (black arrow), and medial wall (white arrow) into sinus lumen.

View larger version (147K): [in a new window]   Fig. 3B. —39-year-old man with 2-month history of diplopia. T2-weighted fat-saturated MR image obtained in coronal plane at a position posterior to A graphically displays inward retraction of posterior (arrow) and medial (arrowhead) walls of right maxillary sinus.

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