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Silent sinus syndrome in children
Monika E Freiser1, Jennifer McCoy2, Amber D Shaffer2
1Department of Otolaryngology - Head and Neck Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Insights
Silent sinus syndrome (SSS) in children often presents with maxillary sinus hypoplasia and orbital changes. Headaches are common, and while observation is frequent, early intervention may prevent long-term complications.
Area of Science:
- Otolaryngology
- Pediatric Ophthalmology
- Radiology
Background:
- Silent sinus syndrome (SSS) involves maxillary sinus atelectasis causing enophthalmos and hypoglobus.
- Literature on SSS in pediatric populations is scarce.
- This study aims to characterize SSS in children.
Purpose of the Study:
- To characterize Silent Sinus Syndrome (SSS) in pediatric patients.
- To compare presentation and outcomes between surgical and observational management.
- To identify common symptoms and clinical features of SSS in children.
Main Methods:
- Retrospective chart review of pediatric patients (ages 1-18) diagnosed with maxillary sinus hypoplasia or SSS.
- Utilized a health system-wide imaging database (2003-2017) for case identification via CT scan reports.
- Collected data on clinical presentation, eye symptoms, surgical treatment, and patient outcomes.
Main Results:
- Identified 83 children with maxillary sinus hypoplasia; 57 exhibited SSS characteristics (hypoglobus/enophthalmos).
- Headache was the most frequent presenting symptom (55%).
- No significant differences in presentation between surgical and observational groups; 19 patients underwent surgery.
Conclusions:
- Silent sinus syndrome (SSS) can occur in children, often associated with maxillary sinus hypoplasia and orbital changes.
- Headaches are a common symptom in pediatric SSS.
- Close follow-up and potential early intervention are recommended to prevent long-term orbital complications.
Introduction:
Silent sinus syndrome (SSS) is defined as a progressive enophthalmos and hypoglobus associated with maxillary sinus atelectasis. There is extremely limited literature describing SSS in children. The goals of this study are to characterize SSS in children through an IRB approval retrospective chart review of cases identified through a large health system-wide imaging database and to compare the presentation and outcomes of patients who underwent surgery versus those who were observed.
Methods:
A radiology database of over 26 million reports from 2003 to 2017 was searched to identify children aged 1-18 years diagnosed with maxillary sinus hypoplasia or SSS on CT scan. Chart review was performed on the identified children including clinical presentation, eye symptoms, surgical treatment, and outcome.
Results:
Eighty-three children were identified to have maxillary sinus hypoplasia. Eighty-one patients had maxillary sinus opacification and 57 patients had hypoglobus or enophthalmos characteristic of SSS. Thirty-two patients (47%) were seen by a specialist and 19 had surgery. The majority of patients (55%) had headache as their presenting symptom. There were no statistically significant differences in the clinical presentation between those who received surgery and those who were observed clinically.
Conclusions:
Silent sinus syndrome can present at any age. The majority of cases of maxillary sinus hypoplasia will have the orbital floor changes characteristic of SSS. Headaches are a common presenting symptom. Close follow up of pediatric patients is advised and early intervention may be favorable to prevent long term orbital changes and complications.
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