P333 Silent sinus syndrome in children (case report)

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Silent sinus syndrome or chronic maxillary sinus atelectasis characterised by asymptomatic hypoplasia of maxillary sinus, progressive enophthalmos, facial asymmetry. Hypoplasia of maxillary sinus caused by its long-term hypoventilation due to anatomical changes in osteomeatal complex. The diagnosis based on clinical features and data of computed tomography. The the majority of documented patients with silent sinus syndrome aged from 30 to 60 years old.

2 case reports of the children with silent sinus syndrome.

1 case. 13 years old girl complained with nasal discharge from the right side during 3 months. Before admitting underwent 2 maxillary sinus punctures, one complicated with orbital oedema. CT scan of paranasal sinuses showed retraction of right maxillary sinus walls, sinus hypoplasia and opacification. Patient underwent endoscopic right maxillary sinus surgery under general anaesthesia. During 3 month follow up girl had normal nasal breathing and no nasal discharge.

2 case. 8 years old girl complained with facial asymmetry, pain in the projection of the right maxillary sinus and right orbita, recurrent sinusitis during last 2 years. Medical treatment was ineffective. CT scan revealed: a completely opacified right maxillary sinus, hypoplasia of the sinus, retraction and thinning of the orbit floor of the right maxillary sinus comparing with left side. Endoscopic right maxillary sinus surgery was performed: after resection of the lateralized uncinated processes the blocked ostium of the maxillary sinus was enlarged posteriorly and anteriorly. During 6-moths follow up period facial asymmetry was stable and there were no symptoms of sinusitis.

So, silent sinus syndrome is a rare entity in children. Endoscopic sinus surgery is effective treatment for this pathology in children, that restore normal development of the paranasal sinuses and facial skeleton.

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