Volumetric analysis of chronic maxillary atelectasis

Area of Science:

• Otolaryngology
• Ophthalmology
• Radiology

Background:

• Chronic maxillary atelectasis (CMA), or silent sinus syndrome, involves poorly understood volumetric changes between the orbit and maxillary sinus.
• Enophthalmos and diplopia are potential clinical manifestations of CMA.

Purpose of the Study:

• To investigate the relationship between orbit and maxillary sinus volumes in patients with CMA.
• To assess volumetric changes before and after endoscopic sinus surgery (ESS).

Main Methods:

• Retrospective review of 22 patients with CMA treated with ESS.
• Volumetric analysis of CT scans for orbit and maxillary sinus dimensions using OsiriX software.
• Comparison of pre- and post-operative volumes, and diseased side versus contralateral side volumes.

Main Results:

• Significant differences in pretreatment orbit and maxillary sinus volumes between the diseased and contralateral sides were observed (p < 0.001).
• A decrease in maxillary sinus volume and an increase in orbit volume were noted in CMA patients.
• Post-ESS, a decrease in orbit volume and an increase in maxillary sinus volume were observed, though volumes did not return to contralateral side levels.

Conclusions:

• Volumetric analysis provides objective evidence of orbit expansion and maxillary sinus contraction in CMA.
• ESS can lead to partial restoration of normal volumes, but complete normalization is not achieved.
• Further research may explore the predictive factors for enophthalmos and long-term volumetric changes.