Silent sinus syndrome: potentially misleading features that should be recognized

Area of Science:

• Otolaryngology
• Ophthalmology
• Neurology

Background:

• Silent sinus syndrome (SSS) typically presents with globe asymmetry and enophthalmos.
• Patients with SSS may exhibit diverse symptoms, leading to misdiagnosis and delayed treatment.
• Early recognition of SSS signs is essential for prompt management.

Purpose of the Study:

• To describe the varied and potentially misleading clinical presentations of Silent Sinus Syndrome (SSS).
• To enhance physician awareness of SSS signs to reduce diagnostic delays.
• To improve the diagnostic accuracy and timeliness of SSS management.

Main Methods:

• A retrospective audit of Silent Sinus Syndrome (SSS) patient records from 2015-2019 at Oxford Eye Hospital.
• Inclusion of demographic and clinical data, focusing on presenting symptoms and referral pathways.
• Analysis of ten SSS cases to identify patterns in presentation and diagnosis.

Main Results:

• Ten patients diagnosed with SSS were analyzed, with a mean age of 42.5 years.
• Presentations varied, with initial referrals to ophthalmology, ENT, maxillofacial, and neurology.
• Symptoms included globe asymmetry, diplopia, eyelid asymmetry, facial asymmetry, infraorbital paresthesia, and headaches.

Conclusions:

• Silent Sinus Syndrome (SSS) demonstrates a wide spectrum of clinical presentations.
• Misleading signs and symptoms can lead patients to various subspecialties, delaying diagnosis.
• Increased physician awareness of SSS's variable presentation is vital to prevent diagnostic delays and reduce patient morbidity.