Silent sinus is said to be mainly caused by the inward withdrawal of the walls on maxillary sinus region. There is yet another condition called the Hypo plastic condition where the region becomes thicker and opaque. The medical world has not been able to exactly distinguish the differences between these two conditions in the initial stages of the illness. It only when the problem has reached an acute or chronic stage, that the difference is identified.
Major problems of this syndrome
One of the major problems associated with this sort of illness is its identification in the initial stages. Moreover this illness is not commonly experienced like the other sinus problems. In most of the cases, the symptoms like mucus formation, allergy, nose blocking etc do not surface. Some patients may suffer from frequent head aches. This symptom usually lasts for about 7 8 days before coming back to somewhat normal condition. It is only when the illness reaches its progressive, stages, that the symptoms are clearly observed. Some such symptoms may be
- Facial asymmetry: This may result in sinking of one of the eyes below the horizontal plane of the other eye.
- Dee superior sulcus: This may result in hollowness in the upper region of eyelid.
- The left /right orbit region surrounding the eye will start sinking: It may also be accompanied by increased volume of that region, in comparison to the other eye.
- In some cases: both the orbit regions may experience sinking. This could be due to the twin sided retraction of maxillary sinus region, though this case happens very rarely.
Though the symptoms have been identified, the exact clinical reasons behind these symptoms are yet to be identified. It is recommended that the patient be taken for immediate diagnosis, even when the slightest of such symptoms appear.
Diagnosis & Treatment
Diagnosis could become tricky because the symptoms may vary in different patients. The first symptom as we saw above is the withdrawal of the walls on maxillary sinus region. In other cases the symptom may vary like
Diagnosis methods usually involve examination of pupillary region, evaluation of the cranial nerve, eyelid alignment, examination of neurogenic junction region etc. Many times it also involves the UV scanning of maxillary sinus region. These examinations will be able to reveal the condition of Silent sinus syndrome to an effective extent.
Once the diagnosis is complete, the treatment phase begins. In most of the cases, the experts recommend surgical method. One of the reasons given by them is that this stage is normally beyond the control by any sort of medication or anti biotic. The surgery aims at normalizing the drainage located at the maxillary sinus region. This is the first stage of surgery.
The second stage would be the normalization of orbital volume, that is reduce the excess gap which occurred due to the retrieval of the maxillary sinus walls and floor. This could be done by implanting the subperiosteal in the orbital floor region. In many cases this is also achieved by reconstructing the orbital floor with medical grade plastic material.