ATELECTASIS OF THE MAXILLARY SINUS WITH ENOPHTHALMOS AND MIDFACE DEPRESSION

Enophthalmos previously has been reported to be a rare complication of maxillary sinus mucoceles. We report three patients treated by the se nior author (T.C.C.) over a 2-month period for enophthalmos or obvious deformity of the midface associated with complete opacification of th e maxillary antrum. Most previous authors have stressed the role of ch ronic pressure necrosis or osteitis leading to bone destruction, with primary involvement of the orbital floor. No patients in this series h ad symptoms typical of sinus mucoceles. Two of our three patients pres ented with minimal symptoms of chronic infection. There was inward col lapse of the anterior, superior, lateral, and medial walls of the maxi llary sinus, with no radiographic or intraoperative confirmation of bo ne destruction. We speculate that this process may be the result of ch ronic maxillary hypoventilation with subsequent atelectasis of the ant rum secondary to chronic negative pressure. All patients had obstructi on at the osteomeatal complex and were treated by endoscopic enlargeme nt of the natural maxillary ostium.