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Published: 2022-06-30
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Silent sinus syndrome: systematic review and proposal of definition, diagnosis and management

Department of Otorhinolaryngology, Santi Paolo e Carlo Hospital, Università degli Studi di Milano, Milan, Italy
Department of Otorhinolaryngology, Santi Paolo e Carlo Hospital, Università degli Studi di Milano, Milan, Italy
Department of Otorhinolaryngology, Santi Paolo e Carlo Hospital, Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
Department of Otorhinolaryngology, Santi Paolo e Carlo Hospital, Department of Health Sciences, Università degli Studi di Milano, Milan, Italy
silent sinus syndrome maxillary atelectasia enophthalmos imploding antrum syndrome silent sinus syndrome management

Abstract

Silent Sinus Syndrome (SSS) is a rare disease consisting of a collapse of maxillary sinus walls with concomitant orbital floor descent. Due to its rareness, the literature highlights some confusion on its definition, diagnosis and management. A PRISMA-compliant systematic review was performed on SSS with focus on definition, diagnosis and therapeutic management. Twenty-eight studies were selected, with 276 patients evaluated. The analysis revealed that the leading definition of SSS includes evidence of both enophtalmos and maxillary atelectasia. Although the definition of SSS accepts only spontaneous sinus collapse, the presence of sinonasal diseases and history of facial trauma are starting to be included in the criteria. Most studies (n = 21) considered CT scans satisfactory for diagnosis of SSS, while 7 also performed MR. The majority of SSS were successfully treated with isolated functional endoscopic sinus surgery (n = 17), sparing orbital reconstruction as a rescue procedure in case of non-satisfactory long-term resolution of signs. Although the literature is starting to coordinate on diagnosis of SSS, our review revealed the necessity of consensus on its definition and management.

Affiliations

Cecilia Rosso

Department of Otorhinolaryngology, Santi Paolo e Carlo Hospital, Università degli Studi di Milano, Milan, Italy

Alberto Maria Saibene

Department of Otorhinolaryngology, Santi Paolo e Carlo Hospital, Università degli Studi di Milano, Milan, Italy

Giovanni Felisati

Department of Otorhinolaryngology, Santi Paolo e Carlo Hospital, Department of Health Sciences, Università degli Studi di Milano, Milan, Italy

Carlotta Pipolo

Department of Otorhinolaryngology, Santi Paolo e Carlo Hospital, Department of Health Sciences, Università degli Studi di Milano, Milan, Italy

Copyright

© Società Italiana di Otorinolaringoiatria e chirurgia cervico facciale , 2022

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