Silent Sinus Syndrome Identified on Impacted Canine Evaluation

A 19-year-old female with no significant medical history was referred for evaluation of an impacted maxillary canine. During full-volume review, the radiologist identified a hypoplastic and opacified right maxillary sinus with an obstructed ostiomeatal unit. The radiographic appearance was suspicious for silent sinus syndrome, and clinical photographs confirmed orbital and facial asymmetry. The radiologist noted that silent sinus syndrome can lead to significant progressive facial asymmetry and may require orbital reconstruction in severe cases. Because the changes develop slowly, they can go undetected for an extended period. The condition is treatable through surgical intervention if the sinus is addressed by an ENT specialist and the ostiomeatal unit becomes patent.