A 45-year-old asymptomatic patient is found to have unilateral maxillary sinus opacification on CT scan performed for headache. The scan shows painless inward retraction of the maxillary sinus walls with orbital floor descent and enlargement of the ipsilateral middle meatus. There is no history of facial trauma or prior sinus surgery. What is the most likely diagnosis?
- A Maxillary sinus mucocele
- B Allergic fungal sinusitis
- C Silent sinus syndrome ✓
- D Chronic maxillary sinusitis with polyposis
Correct answer: C. Silent sinus syndrome
Explanation
Silent sinus syndrome (maxillary atelectasis) is characterized by painless enophthalmos and facial asymmetry caused by chronic negative pressure in the maxillary sinus leading to orbital floor descent and inward retraction of sinus walls. Unlike mucocele, there is no expansile lesion with bony remodeling. It is typically asymptomatic until cosmetic deformity develops. Wisbauch et al., Aesthetic Plastic Surgery.
Reference: Bailey and Love's Short Practice of Surgery, 28th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.