The Atelectatic Maxillary Sinus

Abstract

The atelectatic maxillary sinus is a distinct anatomic variant. It may be identified in a symptomatic patient complaining of recurrent acute or chronic sinusitis or may be found incidentally, presenting as an asymptomatic opacified sinus. Recognition of the disorder is important. Lateral displacement of the posterior fontanelle may lead to the erroneous radiographic diagnosis of an air fluid level. At surgery, the infundibular atelectasis associated with the disorder may give rise to inadvertent orbital entry as the uncinate process is incised. Surgery may be further complicated by lateral displacement of the medial maxillary sinus wall, reducing access to the sinus by the transnasal approach. Although the atelectatic sinus may be identified at any age, its occurrence in childhood and the typical concurrence of sinus hypoplasia suggests sinus hypoventilation from an early age. The characteristic findings of the atelectatic maxillary sinus are presented and its surgery discussed.