Bilateral silent sinus syndrome: case report and surgical solution.

Silent sinus syndrome (SSS) is a rare disorder characterized by ipsilateral enophthalmos and hypoglobus, caused by an alteration of the orbital architecture due to maxillary sinus collapse with chronic hypoventilation.1 Its treatment is surgical, and despite controversies in the literature, simultaneous management of enophthalmos and sinus pathologies existing in the floor of the orbit, reconstruction, and endoscopic uncinectomy and antrostomy should be considered as some of the main options for treatment.2 Despite a considerable number of cases reported, SSS has always been described as occurring unilaterally in the maxillary sinus, and Liss et al3 are the only authors who have reported a case of simultaneous bilateral localization. However, their patient was previously treated with surgery, radiation therapy, and chemotherapy for sinonasal malignancy, and this positive medical history should exclude the diagnosis of SSS.4 We report an extremely rare case of bilateral SSS with the second-side localization occurring 4 months after surgery for the first affected side. Computed tomography (CT) studies, including pre-disease images, are provided.