A Case of Imploding Antrum (Silent Sinus) Syndrome after Orbital Decompression.

Jang, Seung Won; Oh, Dong Eun; Kim, Yoon Duck

doi:2008.49.2.362

J Korean Ophthalmol Soc > Volume 49(2); 2008 > Article

Case Report

Journal of the Korean Ophthalmological Society 2008;49(2):362-367.
DOI: https://doi.org/10.3341/jkos.2008.49.2.362 Published online February 29, 2008.

A Case of Imploding Antrum (Silent Sinus) Syndrome after Orbital Decompression.

Seung Won Jang, Dong Eun Oh, Yoon Duck Kim

¹Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. ydkimoph@skku.edu
²Department of Ophthalmology, Korea Veterans Hospital, Seoul, Korea.

안와감압술 후 발생한 내파열 동(Imploding antrum, silent sinus) 증후군 1예

장승원¹ㆍ오동은²ㆍ김윤덕¹

"Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine1, Seoul, Korea Department of Ophthalmology, Korea Veterans Hospital2, Seoul, Korea"

Correspondence: Seung Won Jang, M.D.1

Abstract

PURPOSE
Imploding antrum (silent sinus) syndrome has clinical features of enophthalmos and hypoglobus after a downward collapse of inferior orbital wall with an ipsilateral volume decrease of maxillary sinus. We present a case of imploding antrum syndrome after an orbital decompression surgery. CASE SUMMARY: A 26-year-old female underwent inferomedial wall orbital decompression surgery through a caruncular approach to reduce exophthalmos. At 14 months after surgery, her right eye showed 2 mm of enophthalmos and orbital CT scan revealed both maxillary sinusitis. At 28 months after surgery, 3 mm of enophthalmos and hypoglobus of the right were observed, and an orbital CT scan was taken. Orbital CT scan showed a downward collapse of inferior orbital wall, a volume decrease and inward bowing of the maxillary sinus, and a maxillary opacification on the right side, which are typical findings of imploding antrum (silent sinus) syndrome. CONCLUSIONS: Imploding antrum (silent sinus) syndrome after orbital decompression surgery is a rare complication. Considering that any prolapsed orbital fat after orbital decompression surgery could result in imploding antrum syndrome with hypoventilation of a maxillary sinus, care should be taken to keep the maxillo-ethmoidal interface (bony strut) intact, which helps maintain maxillary aeration.

Key Words: Imploding antrum syndrome;Orbital decompression