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Clinical Problem Solving: Radiology
January 2002

Diganosis Radiology Quiz Case 2

Author Affiliations


Arch Otolaryngol Head Neck Surg. 2002;128(1):83. doi:

Otolaryngologists are familiar with the common symptoms associated with acute and chronic sinusitis. Patients will present with congestion, rhinorrhea, pressure, or facial pain. Also, there are the orbital complications described by Chandler et al.1 However, there are a few patients who present with orbital structural changes associated with maxillary atelectasis. The silent sinus syndrome has been described by such authors as Montgomery2 and Wilkins and Kulwin.3 Wilkins and Kulwin's standard description of spontaneous enophthalmos with chronic maxillary sinusitis includes the inferior displacement of the orbital floor, where the globe sinks downward and backward, creating a narrowing of the palpebral fissure, with a sunken or hollow appearance above the eye and an increased superior sulcus.3

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