[Silent sinus syndrome, a rare outcome of an orbital floor fracture].

Abstract

A 28-year-old man was referred to an oral and maxillofacial surgeon, complaining of fatigue, a tugging sensation in his right eye and difficulty focusing. Closer investigation revealed a progressive shifting of the position of the right eyeball as a result of silent sinus syndrome, as a delayed consequence of an orbital floor fracture. Although clinical symptoms usually occur soon after an orbital fracture, there are dormant sequelae that only develop later, such as the silent sinus syndrome. Displacement of the orbital floor can cause the infundibulum of the maxillary sinus to the nose to become obstructed. This can create a vacuum in the maxillary sinus which pulls the walls inwards. Since the roof of the sinus is also the floor of the orbit, a slow yet progressive change in the position of the eyeball can occur. In addition to a traumatic cause (orbital floor fracture), chronic sinusitis, possibly of odontogenic origin, can also be the cause of silent sinus syndrome. Early referral to an oral and maxillofacial surgeon prevents worsening of this syndrome.