Silent Sinus Syndrome in a Paediatric Patient: An Incidental Diagnosis Following Facial Trauma

Silent sinus syndrome (SSS) is a rare condition characterised by spontaneous unilateral atelectasis of a paranasal sinus, most commonly the maxillary sinus, typically presenting in adults with progressive enophthalmos and hypoglobus. Paediatric cases are uncommon and may present subtly, often lacking the classic features observed in adults. We report an incidental diagnosis of SSS in a 13-year-old boy following minor facial trauma. Clinical assessment raised the concern for a facial fracture due to subtle malar asymmetry. Plain radiographs demonstrated right maxillary sinus opacification with associated malar asymmetry, without obvious fracture, prompting further imaging. Computed tomography excluded an acute fracture but revealed changes consistent with SSS. The patient underwent functional endoscopic sinus surgery (FESS) to prevent disease progression. This case highlights the importance of considering SSS in trauma presentations where clinical findings and radiographic appearances are incongruent. Early recognition is essential to prevent progressive facial deformity and potential visual complications, particularly in the paediatric population.