(A1102) Acquired Post-Infectious Silent Sinus Syndrome in a Pediatric Patient

Introduction: Silent sinus syndrome, a rare condition characterized by progressive enophthalmos and hypoglobus with associated maxillary sinus atelectasis, is infrequently observed in the pediatric population. Here, we present a case of post-infectious silent sinus syndrome in a pediatric patient.

Methods: This is a case report of a single patient treated at our institution between 2023-2025.

Results: An 11-year-old female with a history of chronic sinusitis was transferred to our hospital from an outside facility for the management of post-COVID sinusitis, which was complicated by Streptococcus pyogenes septic shock and preseptal orbital cellulitis. Initial CT imaging of the sinuses revealed symmetric maxillary sinuses with complete opacification on the right side. The patient was successfully treated with medical management and subsequently underwent an adenoidectomy two months later.
Despite treatment with maintenance Flonase and Astepro, she continued to experience recurrent sinusitis over the following 1.75 years. A follow-up CT scan of the sinuses revealed significant right maxillary sinus atelectasis and bowing of the inferior orbital wall. A tentative plan for a right maxillary antrostomy has been proposed. The post-operative outcomes are to be presented at a conference, pending abstract acceptance.

Conclusions: This case highlights a rare instance of acquired post-infectious silent sinus syndrome in a pediatric patient, demonstrating the condition's progression over two years. Radiographic images will enhance the presentation of the natural perioperative progression. The planned right maxillary antrostomy aims to address maxillary sinus patency, with post-operative outcomes to be shared at an upcoming conference, pending abstract acceptance.