Beyond the Maxillary Sinus: A Proposed Classification of Chronic Sinus Atelectasis

Chronic maxillary atelectasis (CMA) describes the loss of maxillary sinus volume and has been well-described in the literature under many different names, creating inconsistency in reporting. A recent proposal has standardized the nomenclature but does not include disease of other paranasal sinuses.

We describe a unique case of chronic ethmoid atelectasis, briefly review literature associated with CMA, and propose an expanded classification of chronic sinus atelectasis.

A 70-year-old man presented to the emergency department with transient vision loss and was incidentally found to have sinus opacification on MRI. At his otolaryngology follow-up, he did not have any signs of sinonasal symptoms, hypoglobus, or enophthalmos. CT confirmed sinus opacification which was correlated with lateralized left middle turbinate and uncinate process. The patient underwent functional endoscopic sinus surgery to correct the anatomical changes.

The spectrum of atelectasis affecting the ethmoids mirrors what has been described for CMA, potentially indicating a similar disease process affecting different areas. If this falls along the same spectrum of disease, the grading system applied to CMA may be applied to other paranasal sinuses.