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Endoscopic Septoplasty with Limited Two-line Resection: Minimally Invasive Surgery for Septal Deviation
Published on: June 20, 2018
Silent Sinus Syndrome: 13-Year Experience With Endoscopic Surgery and Long-Term Patient Outcomes
Sholem Hack1, Arkadi Yakirevitch2,3, Gabriel Nakache2,3
1City St. George's University London School of Medicine, Program Delivered by University of Nicosia at the Chaim Sheba Medical Center Ramat Gan Israel.
Summary
Silent sinus syndrome (SSS) management with endoscopic sinus surgery offers durable symptom relief and improved quality of life. Orbital floor reconstruction is typically not required for SSS patients.
Area of Science:
- Otolaryngology
- Ophthalmology
- Plastic Surgery
Background:
- Silent sinus syndrome (SSS) involves maxillary sinus collapse and orbital deformity.
- Limited data exists on long-term outcomes and surgical management of SSS.
Purpose of the Study:
- Evaluate long-term clinical and patient-reported outcomes of endoscopic sinus surgery for SSS.
- Assess the necessity of concurrent orbital floor reconstruction in SSS cases.
Main Methods:
- Retrospective case series of 24 adult SSS patients undergoing functional endoscopic sinus surgery (FESS) from 2012-2024.
- Review of clinical records, CT imaging, and long-term follow-up via clinic visits and interviews.
- Assessment of symptom resolution, ocular changes, need for further procedures, and quality of life.
Main Results:
- All 24 patients showed maxillary sinus atelectasis and orbital floor retraction.
- FESS was performed in all cases; only one patient (4.2%) needed orbital reconstruction.
- Mean follow-up of 4.71 years revealed complete symptom resolution and improved ocular findings, with a mean quality-of-life score of 4.58/5.
Conclusions:
- Endoscopic sinus surgery is highly effective and durable for SSS management.
- No SSS recurrences were observed with excellent long-term patient-reported outcomes.
- Orbital floor reconstruction is generally unnecessary, reserved for persistent diplopia or cosmetic issues.
