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Silent sinus syndrome: an unusual case of facial numbness
  1. Samuel Tribich1,
  2. Colin J Mahoney2,
  3. Nicholas W Davies2,3
  1. 1 Department of Medicine, Royal Free London, NHS Foundation Trust, London, UK
  2. 2 Department of Neurology, Royal Prince Alfred Hospital, Sydney, New South Wales, Australia
  3. 3 Department of Neurology, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
  1. Correspondence to Dr Colin J Mahoney, Department of Neurology, Royal Prince Alfred Hospital, Sydney, NSW 2050, Australia; colinmahoney{at}


A 49-year-old man presented with a 1-week history of right facial paraesthesia with blurred vision and diplopia. Examination was normal apart from reduced facial sensation. Following appropriate neuroimaging, we considered a diagnosis of silent sinus syndrome. He underwent a middle meatal antrostomy with complete resolution of symptoms. Silent sinus syndrome results from occlusion of the osteomeatal complex, preventing normal aeration of the maxillary sinus. Maxillary sinus hypoventilation typically causes inferior displacement of the globe in the orbit (unilateral hypoglobus). Neurologists will only infrequently see people with silent sinus syndrome but it can have devastating consequences if left untreated and so must be considered in the appropriate clinical context.

  • clinical neurology
  • ENT
  • ophthalmology

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  • Contributors ST reviewed the literature and drafted the paper. CJM an NWD assessed and diagnosed the patient. CJM redrafted the paper for submission.

  • Funding The authors receive salaries as employees of the National Health Service (ST, NWD) and New South Wales Health (CJM). No external funding was sought.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally reviewed. This paper was reviewed by Robin Howard, London, UK.

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