MAXILLARY SINUS ATELECTASIS WITH ENOPHTHALMOS

Chronic maxillary sinusitis may present as atelectasis of the sinus wi th changes to surrounding structures. Several mechanisms have been pro posed for this problem. Chronic obstruction of the sinus ostium, with resultant retention of secretions and osteitic bone resorption, may ac count for these changes. Enophthalmos is one manifestation that may re quire corrective treatment. Titanium micromesh reconstruction of the o rbital floor, with or without onlay concha cartilage, has reliably res olved the enophthalmos. Reconstruction of the orbital floor and ventil ation of the obstructed sinus ostium may be carried out relatively saf ely in a single operation. The standard endoscopic technique of uncina te removal and middle meatal antrostomy should be modified to prevent orbital penetration. This report reviews our series of 6 patients with this problem, as well as a comprehensive review of the literature. Re commendations for management of both the obstruction and the secondary orbital manifestations are presented.