Spontaneous enophthalamos and hypoglobus associated with the silent si
nus syndrome are disfiguring for the patient and create functional pro
blems, such as lagophthalmos and audible clicking while blinking. We d
escribe a surgical technique that was used to successfully treat two p
atients with this disorder of maxillary sinus hypoplasia and orbital f
loor resorption. Two patients underwent transconjunctival exploration
of the involved orbital floor with simultaneous Caldwell-Luc procedure
. The floor was elevated by packing the maxillary sinus, and the remai
nder of the orbital soft-tissue volume disparity was filled with eithe
r autogenous nasal septal cartilage or banked irradiated costochondral
cartilage. Both patients had uncomplicated, complete resolution of th
eir functional problems and cosmetic disfigurement. These patients rem
ained clinically stable for a 1-year follow-up period. This technique
appears to be a safe and effective means to correct the functional and
cosmetic abnormalities associated with the silent sinus syndrome.