Abstract
Objective
Silent sinus syndrome (SSS) usually manifests clinically as hypoglobus and enophthalmos.
Patients may experience different symptoms and may present to an assortment of specialties
and delay diagnosis and management. The objective of this article was to describe
the different and sometimes misleading signs and symptoms of SSS to improve the level
of suspicion and reduce time to diagnosis.
Methods
A retrospective consecutive audit of the records of all patients diagnosed with SSS
between 2015 and 2019 in the Oxford Eye Hospital, Oxford University Hospitals NHS
Foundation Trust. Demographic and clinical data including presentation, diagnosis,
and symptoms were obtained from the patients’ medical files.
Results
Ten patients were included; mean age was 42.5 ± 11.5 years (range, 16–56 years). Four
patients were initially referred to an ophthalmologist with globe asymmetry, diplopia,
eyelid asymmetry, or retraction. Three patients were initially referred to an ear,
nose, and throat specialist with facial asymmetry or infraorbital paraesthesia. Two
patients were referred from the maxillofacial department with an incidental finding,
and the last patient was seen initially by the neurology team with headaches.
Conclusion
SSS has a variable presentation. Patients may have common or misleading signs. Patients
may attend different clinics and subspecialties, and physicians should be aware of
the broad range of presenting signs in this condition to prevent delay in diagnosis
and further morbidity.
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Article Info
Publication History
Published online: October 26, 2021
Accepted:
September 27,
2021
Received in revised form:
September 16,
2021
Received:
March 1,
2021
Publication stage
In Press Corrected ProofIdentification
Copyright
© 2021 Published by Elsevier Inc. on behalf of Canadian Ophthalmological Society.