Simultaneous Endoscopic Antrostomy and Orbital Reconstruction in Silent Sinus Syndrome

Purpose: To review the surgical outcome of five cases of silent sinus syndrome (SSS) who were treated with simultaneous endoscopic antrostomy and orbital implant placement. Patients with SSS often present with cosmetic change to their facial appearance (enophthalmos, hypoglobus, deep upper lid sulcus). Design: Retrospective case series. Methods: Chart review was performed for cases of SSS who were seen between 1995 and 2003 in two tertiary eye care centers. The age, affected side, presenting symptoms and duration, history of trauma, smoking, and chronic sinusitis, degree of enophthalmos and hypoglobus were recorded. Results: All patients had a satisfactory post-operative result with correction of the enophthalmos, hypoglobus, and deep upper lid crease deformity. There were no untoward effects such orbital implant infection, diplopia, vision loss or hematoma. Conclusion: Simultaneous endoscopic antrostomy and orbital implant placement can achieve a satisfactory outcome in cases of SSS with significant enophthalmos and hypoglobus. Orbital implant placement carries minimal risks and should not be delayed only to potentially avoid infection, diplopia, or visual loss, as these events are unlikely.