Decrease In Sinus Volume Research Articles

Volumetric Analysis of Chronic Maxillary Atelectasis

The relationship between orbit and maxillary sinus volumes in patients with chronic maxillary atelectasis (CMA), commonly known as silent sinus syndrome if enophthalmos is present, is poorly understood. A retrospective review of 22 patients who underwent endoscopic sinus surgery (ESS) for CMA from 2005 to 2013 was performed. Computed tomography (CT) images were analyzed using OsiriX 5.8.2 software for volumetric analysis of the orbit and maxillary sinus at presentation and after surgical treatment with ESS. Pretreatment mean orbit volumes on the diseased side (DS) and the contralateral side (CS) were 29.22 and 26.50 mL, respectively (p < 0.001); mean sinus volumes on the DS and CS were 8.51 and 17.20 mL, respectively (p < 0.001); and pretreatment mean midorbit heights (MOHs) on the DS and CS were 3.39 cm and 3.07 cm, respectively (p < 0.001). The percent decrease in sinus volume on the DS compared to that on the CS did not correlate significantly with the percent orbit-volume increase. Enophthalmos was present in nine (41%) patients, and diplopia was present in three (14%) patients. The measured degree of increased orbit volume and decreased sinus volume secondary to CMA did not significantly predict the presence of enophthalmos at presentation. Seven patients underwent sinus CT more than 6 months after ESS. In these patients, orbit volume on the DS decreased from 29.67 to 27.52 mL (p = 0.005), and sinus volume on the DS increased from 9.78 to 11.84 mL (p = 0.08). Volumetric analysis is a powerful and novel method for objectively demonstrating the degree of orbit expansion and maxillary sinus contraction seen with CMA. Spontaneous maxillary sinus expansion and a decrease in orbit volume can occur after ESS, but post-ESS volumes do not return to the normal volume of the CS.

Progressive Maxillary Sinus Hypoplasia With Open Ostium

Maxillary sinus hypoplasia (MSH) is an uncommon clinical entity that represents a persistent decrease in sinus volume resulting from a centripetal retraction of the maxillary sinus walls. Pathophysiology of MSH is still controversial. Obstruction of the maxillary sinus ostium and negative pressure in the sinus has been mostly implicated in the development of MSH in most of the reported cases. We present a case of progressive unilateral MSH, which has an open ethmoid infundibulum and also presence of an open accessory ostium on the same side. Based on these findings, we propose that ventilatory dysfunction resulting from ostial obstruction alone cannot be accepted as the primary and sole etiologic factor in the pathogenesis of MSH.

Surgical management of chronic maxillary atelectasis

Chronic maxillary atelectasis (CMA) results from valvular occlusion of the natural ostium of the maxillary sinus by the medial infundibular wall. This uncommon condition is characterized by a chronic decrease in sinus volume caused by inward bowing of one or more antral walls. In some instances, visual and cosmetic problems can occur as a consequence of severe osseous wall deformation. CMA is seen in both children and adults, and radiological evidence of complete antral opacification and fontanel retraction is considered diagnostic of the disorder in both populations. Treatment goals are the same for all age groups and include complete antral drainage and restoration of good ventilation.