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AJNR - American Journal of Neuroradiology

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Silent Sinus Syndrome: An Acquired Condition

Roula Hourany^a, Nafi Aygun^a, Charley C. Della Santina^b and S. James Zinreich^a

^a Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins Medical Institutions, Baltimore, MD
^b Departments of Otolaryngology Head and Neck Surgery and Biomedical Engineering, Johns Hopkins School of Medicine, Baltimore, MD

View larger version (101K): [in a new window]   FIG 1. (A) Coronal, (B) transverse, and (C) sagittal CT images of the sinuses show inward retraction of all walls of the right maxillary sinus with enlargement of the orbit and the middle meatus. The uncinate process is not clearly visualized because it is markedly thinned and retracted to the inferomedial orbital wall (confirmed with nasal endoscopy). (D) Thick-slab volume reconstruction in the coronal plane and (E) curved reconstruction along the optic nerves better demonstrates the maxillary sinus volume loss and enlargement of the orbit and middle meatus.

View larger version (115K): [in a new window]   FIG 2. Frontal view of the patient, demonstrating hypoglobus and enophthalmos of the right eye.

View larger version (119K): [in a new window]   FIG 3. Coronal sinus CT of the patient obtained 10 years previously, before nasal septal reconstruction and rhinoplasty with lateral osteotomies, shows normal sinuses.