CHRONIC MAXILLARY ATELECTASIS

Chronic maxillary atelectasis is a descriptive term that refers to a p ersistent decrease in the sinus volume of the maxilla from inward bowi ng of the antral walls. Case reports with comparable clinical presenta tions have appeared sporadically in the literature; however, this diso rder has remained poorly defined. The purpose of this study is to prov ide a formal definition of this condition by the establishment of diag nostic and staging criteria. A 10-year case analysis identified 22 adu lts, and a review of the literature revealed another 25. The average a ge at presentation in our study was 38.3 years. Most patients were sym ptomatic, and some presented with diplopia and hypoglobus. Inward bowi ng of the antral wall(s) and persistent opacification on computed tomo graphy made the diagnosis. Chronic maxillary atelectasis was separated into three stages according to the degree of wall deformation. While most patients were symptomatic, a past history of absent or mild sympt oms referable to the nose and sinuses was encountered more often in th ose patients with osseous wall deformation (p = .041). Mild or absent symptoms at the time of diagnosis should not be considered a negative risk factor for the development of facial deformity, especially if the sinus has features consistent with complete pneumatization. A middle meatal antrostomy appears to relatively safely correct the sinus probl em, while orbital floor reconstruction for hypoglobus, found in stage III of the disease, can be accomplished effectively via a transconjunc tival approach using a combination of bone allograft and porous polyet hylene sheets.