Post-traumatic Sinus Syndrome, Proposal for a New Clinical Entity (CDR Syndrome) as Variant of the Silent Sinus Syndrome: Systematic Review and Case Series

Abstract

The diagnostic criteria for silent sinus syndrome (SSS) are still controversial, especially for the post-traumatic/surgery cases that are, nowadays, excluded from the diagnosis of SSS because lacking of spontaneously. We present a systematic review of the last 10 years and our case series of SSS associated to previous trauma/surgery, proposing a new interpretation of SSS. In this work, following the PRISMA guide lines for systematic reviews, we collected 86 articles published on PubMed, Cochrane Library and Medline Plus since 2013 to 2023 about SSS. We divided them in six groups forming the structure of the review: (1) epidemiology, (2) clinical presentation, (3) imaging, (4) etiopathogenesis, (5) sss and craniofacial trauma and (6) treatment. We reported two explicative clinical cases: two men of 34 and 37 years old, involved in motorcycle accident in 2020 and 2014, respectively, and underwent surgery. They came back in 2023 referring diplopia documented by Hess-Lancaster test. CT-scan reported two clear cases of SSS. Basing on what is reported in literature, and basing on our experience, the post-traumatic/surgery SSS are more frequent than the idiopathic ones. Our proposal is to considered them as two individual entities. We propose to adopt the name of Post-traumatic sinus syndrome, or CDR syndrome (Catalfamo-De Rinaldis), for all cases that respect four specific diagnostic criteria reported into the text.

Keywords: Chronic maxillary atelectasis; Diplopia; Enophthalmos; Hess-lancaster test; Maxillary sinus hypoplasia; Maxillofacial trauma; Post-traumatic sinus; Silent sinus syndrome.

Fig. 1

Axial and frontal scan and 3-D reconstruction of immediate post-traumatic event

Fig. 2

Hess-Lancaster test performed on December 2022

Fig. 3

December 2022 CT-scan: enophthalmos, hypoglobus and globes asymmetry

Fig. 4

CT-scan of December 2022 with the measures of the antra and of the orbital cavities volume

Fig. 5

3-D reconstruction of the facial skull of patient that shows the presence of plate and screws

Fig. 6

Hess-Lancaster test performed in May 2023

Fig. 7

CT-scan of May 2023