Regular articleClinical and radiologic characteristics of the imploding antrum, or “silent sinus,” syndrome☆
Section snippets
Patients and methods
The clinical records were reviewed for all patients who, between 1990 and 2000, had been given a diagnosis of imploding antrum syndrome after attending the Orbital Clinic at Moorfields Eye Hospital. The presenting symptoms and signs were recorded and, in those not choosing surgical treatment, the natural history noted.
The radiologic changes on computed tomographic scans of the orbit (and sinuses, where available) were reviewed—independently of clinical details—by two radiologists (LH, IM).
Patient 4
A 42-year-old man was referred to the Orbital Clinic, having noted a rapidly progressive painless “dropping” of the right eye approximately 3 months before the clinic visit. With the exception of a brief episode of diplopia, he was otherwise asymptomatic and had no past medical problems, injuries, or surgery.
He had a Snellen acuity of 6/5 in either eye, with no optic neuropathy and no intraocular disease on either side. There was 2 mm of right relative enophthalmos and 4 mm of right hypoglobus,
Clinical features
Fourteen patients (seven men) between the ages of 25 and 78 years (mean, 41.3 years; median, 39 years) who had been symptomatic for between 1 and 36 months (mean, 8 months; median, 6.5 months; Table 1) were treated for imploding antrum syndrome. The right eye was affected in 8 of 14 (57%) cases.
All patients had noted a change in facial appearance, either a ‘sunken eye’ appearance or deepening of the upper lid sulcus, and six patients mentioned intermittent vague discomfort around the affected
Discussion
The pathognomonic clinical features of the imploding antrum, or silent sinus,2 syndrome are spontaneous, fairly rapidly progressive, unilateral enophthalmos and hypoglobus resulting from a downward bowing of the orbital floor in the absence of significant symptomatic chronic sinonasal disease. In both the previously reported cases2 and the present series, the condition would seem to present almost exclusively in the third through fifth decades of life, with symptoms resulting from an expansion
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2022, Otolaryngology Case ReportsCitation Excerpt :This condition is more commonly seen in adults but has also been described in children. Radiographic findings seen with SSS include unilateral maxillary sinus volume loss and opacification, depression of the ipsilateral orbital floor, blockage of the osteomeatal complex, septal deviation, and lateralization of the ipsilateral uncinate process [3]. In order to prevent further orbital complications, it is agreed that the mainstay of treatment for SSS involves surgical intervention aimed at improving maxillary sinus aeration [4].
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2020, International Journal of Surgery Case ReportsCitation Excerpt :However, some cases of children have also been reported; the youngest patient of the SSS described in the literature is seven years old [16]. The signs and symptoms of SSS include: Enophthalmos, hypoglobus, apparent retraction of the eyelid which is secondary to dystopia of the lid and globe, lid lag and lagophthalmos, ocular motility is usually preserved, but gaze can be restricted, headache, sinking of eye or pulling sensation of eye, orbital asymmetry, deepening of superior sulcus, diplopia, eyelid ptosis, exophthalmos of contralateral eye, audible clicking sound with blinking because air is trapped in the conjunctival recess, painless and mild non-specific ache in the orbital tissues, or dental pain [1,17]. The patient presented here, had some of the typical symptoms like; hypoglobus, headaches, sinking of the eye, eyelid ptosis, and dental pain.
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Manuscript no. 210690