Silent sinus syndrome

Purpose of review Symptoms of diplopia, abnormal eyelid signs (retraction, ptosis, absent crease), ocular asymmetry (hypoglobus, enophthalmos), and dry eyes from lagophthalmos could all indicate the diagnosis of silent sinus syndrome. It is important for the physician to be updated on this relatively rare clinical entity. Recent findings Silent sinus syndrome lies on a spectrum of other forms of sinus-related orbitopathy. Uncommon presentations and descriptions of sinus involvement other than the maxillary sinus add to the variability of presentation. Radiographic features of disease include an opacified and hypoplastic sinus, a lateralized uncinate process, depression of the orbital floor, and a blocked osteomeatal complex. Management of silent sinus syndrome may include a single or multistage surgical approach, or a nonsurgical approach. Summary This review discusses silent sinus syndrome from a neuro-ophthalmological perspective.