A 35-year-old presents with spontaneous enophthalmos and hypoglobus on the right side. CT shows a completely opacified right maxillary sinus with inward retraction of the sinus walls and orbital floor displacement. There is no history of sinusitis or trauma. What is the diagnosis?
- A Maxillary sinus mucocele
- B Silent sinus syndrome ✓
- C Maxillary sinus carcinoma
- D Orbital blowout fracture
Correct answer: B. Silent sinus syndrome
Explanation
Silent sinus syndrome is characterized by spontaneous enophthalmos and hypoglobus due to chronic maxillary sinus hypoventilation from obstruction of the ostium. This leads to negative pressure, mucosal thickening, and inward retraction of the orbital floor without prior sinusitis symptoms. CT shows a fully opacified maxillary sinus with downward bowing of the orbital floor. It is distinct from mucocele (which is expansile with bone remodeling) and malignancy (which shows bone destruction).
Reference: Cummings Otolaryngology, 7th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.