Silent Sinus Syndrome on Pre-Frenuloplasty TMJ and Airway Analysis

A 27-year-old male with a history of tongue tie, snoring, TMJ discomfort, and clenching was referred for TMJ and airway analysis prior to lingual functional frenuloplasty. The radiologist identified complete opacification of the right maxillary sinus with reduced volume, inward bowing of the sinus walls, inferior displacement of the orbital floor, and lateralization of the uncinate process, findings consistent with silent sinus syndrome. The left maxillary sinus also showed near-complete opacification with ostiomeatal obstruction, consistent with chronic sinusitis. Silent sinus syndrome is a rare condition where chronic ostial obstruction creates negative intrasinus pressure, causing painless sinus changes that can lead to enophthalmos, hypoglobus, and facial asymmetry. ENT referral was recommended.