THE SILENT SINUS - A CAUSE OF SPONTANEOUS ENOPHTHALMOS

Purpose: Spontaneous enophthalmos and hypoglobus, in the absence of ot her symptoms and unrelated to trauma or surgery, may be alarming to bo th physician and patient. The authors describe the clinicopathologic f eatures of a benign syndrome (''silent sinus syndrome'') with this con stellation of features and discuss the possible pathophysiology. Metho ds: A multicenter retrospective search for similar clinical cases was performed. All clinical records, computed tomographs, and pathology re ports for each case were reviewed at one center. A literature search f or similar cases also was conducted. Results: Nineteen cases of a new syndrome are presented. This syndrome affects individuals at approxima tely the fourth decade of life (average age, 36 years; range, 29-46 ye ars); is characterized by bone resorption and remodeling of the orbita l floor due to otherwise asymptomatic maxillary sinus disease; is asso ciated with ipsilateral maxillary sinus hypoplasia; and is not fully e xplained by any previously described, classic cystic lesion of the max illary antrum. Conclusion: Enophthalmos and hypoglobus unassociated wi th prior trauma, surgery, or other symptoms may represent ''silent sin us syndrome,'' which is ipsilateral maxillary sinus hypoplasia and orb ital floor resorption.