Management of enophthalmos from silent sinus syndrome with a customized orbital implant

Background We describe the surgical treatment of silent sinus syndrome, a disease characterized by progressive enophthalmos and hypoglobus due to orbital floor collapse with opacification of the maxillary sinus, in the presence of chronic maxillary sinusitis. Methods Case study of a 55-year-old male with persistent diplopia secondary to left-sided esotropia and enophthalmos from chronic maxillary sinusitis. Results Two stage procedure to treat the sinonasal and orbital symptoms, which include endoscopic sinus surgery to treat the underlying the ostial obstruction along with decompression of maxillary sinus. Then, reconstruction of the orbital floor with a customized implant. Conclusions Though the treatment of silent sinus syndrome can be challenging, we demonstrate the successful use of a customized orbital implant in the treatment of diplopia and enophthalmos from silent sinus syndrome using a two-stage approach.