Orbital Complications After Cochlear Implant Surgery in a Patient With Silent Sinus Syndrome

Cochlear implantation is an effective procedure for treating patients with severe to profound sensorineural hearing loss. Silent sinus syndrome (SSS) is an uncommon disease that affects the maxillary sinus. It is diagnosed clinically and confirmed radiologically. This study describes the case of a four-year-old child who presented with bilateral profound congenital hearing loss with a family history of congenital hearing loss. The patient had no significant complaints regarding the paranasal sinuses or orbits. Radiological evaluation, including temporal bone computed tomography (CT) and magnetic resonance imaging (MRI) of the ear and internal auditory meatus, showed normal anatomy of the inner ear and petrous bone bilaterally. However, findings of SSS were incidentally detected in the left maxillary sinus. The patient underwent bilateral simultaneous cochlear implantation. On the second postoperative day, he developed left-sided ophthalmoplegia, pain on eye movement, mild proptosis, and upper and lower eyelid swelling with erythema and tenderness. The patient improved rapidly following antibiotic treatment and was almost normal by the fifth postoperative day with no notable findings; hence, he was discharged. Surgeons should carefully evaluate preoperative radiological images of the paranasal sinuses for any malformation or pathology, so that appropriate medical or surgical treatment can be given.