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Stage II Chronic Maxillary Atelectasis Associated with Subclinical Visual Field Defect
João Mangussi-Gomes1, Márcio Nakanishi1, Maria Regina Chalita2
1Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital of Brasília, University of Brasília, Brasília/DF, Brazil.
International Archives of Otorhinolaryngology
|May 21, 2015
Summary
Chronic maxillary atelectasis (CMA) can cause visual field defects. A stage II CMA case presented with a subclinical visual field defect, which resolved after endoscopic sinus surgery.
Area of Science:
- Otolaryngology
- Ophthalmology
- Radiology
Background:
- Chronic maxillary atelectasis (CMA) involves reduced maxillary sinus volume and inward bowing of its walls.
- CMA is classified into three clinical-radiological stages based on severity.
- Ostiomeatal obstruction leading to negative sinus pressure is the primary cause of CMA.
Observation:
- A 34-year-old woman with a history of sinusitis and facial discomfort presented with stage II CMA.
- Computed tomography (CT) revealed a completely opacified right maxillary sinus with characteristic inward bowing.
- Computerized campimetry (CC) detected a visual field defect (scotoma) in the right eye, suggesting optic nerve compromise.
Findings:
- The patient underwent functional endoscopic sinus surgery to drain the opacified maxillary sinus.
- Post-surgery, the patient became asymptomatic with normal postoperative CT and CC results.
- This case highlights the association between stage II CMA and subclinical visual field defects.
Implications:
- CMA, typically presenting with sinonasal symptoms, can manifest with visual disturbances.
- Early diagnosis and surgical intervention for CMA may prevent or reverse optic nerve damage.
- This case expands the understanding of CMA's clinical spectrum beyond typical nasosinusal manifestations.
