The silent sinus syndrome: protean manifestations of a rare upper respiratory disorder revisited

Silent Sinus Syndrome (SSS) is known to be a rare clinical condition, characterized by spontaneous and progressive enophthalmos and hypoglobus associated with atelectasis of the maxillary sinus and alteration of the orbital floor. Most of the patients with this syndrome present with ophthalmological complaints without any nasal sinus symptoms, and it typically has a painless course and slow development, ergo the term "silent." Here we present a case report of a patient with occasional coughing spells as the presenting symptom of Silent Sinus Syndrome, which has not been previously described in the literature. The CT scan findings suggested chronic rhinosinusitis. The radiological findings were suggestive of maxillary sinus hypoplasia, with evidence of maxillary sinus atelectasis. Awareness of this syndrome is important for specialists who work with nasal sinus disease, since its management is different than chronic rhinosinusits.