Short communication
Silent sinus syndrome. Clinical case
Síndrome del seno silente. Caso clínico
L. Gómez
, E. Fontán, J.C. León, J. Garrido
Corresponding author
Servicio de Oftalmología, Hospital Valle de los Pedroches, Pozoblanco, Córdoba, Spain
Read
2006
Timeswas read the article
235
Total PDF
1771
Total HTML
Share statistics
array:24 [ "pii" => "S2173579414000681" "issn" => "21735794" "doi" => "10.1016/j.oftale.2014.05.006" "estado" => "S300" "fechaPublicacion" => "2014-03-01" "aid" => "404" "copyright" => "Sociedad Española de Oftalmología" "copyrightAnyo" => "2012" "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Arch Soc Esp Oftalmol. 2014;89:121-3" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 2025 "formatos" => array:3 [ "EPUB" => 19 "HTML" => 1771 "PDF" => 235 ] ] "Traduccion" => array:1 [ "es" => array:19 [ "pii" => "S0365669112004078" "issn" => "03656691" "doi" => "10.1016/j.oftal.2012.07.029" "estado" => "S300" "fechaPublicacion" => "2014-03-01" "aid" => "404" "copyright" => "Sociedad Española de Oftalmología" "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Arch Soc Esp Oftalmol. 2014;89:121-3" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 2872 "formatos" => array:3 [ "EPUB" => 16 "HTML" => 2353 "PDF" => 503 ] ] "es" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Comunicación corta</span>" "titulo" => "Síndrome del seno silente. Caso clínico" "tienePdf" => "es" "tieneTextoCompleto" => "es" "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "121" "paginaFinal" => "123" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Silent sinus syndrome. Clinical case" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0020" "etiqueta" => "Figura 4" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr4.jpeg" "Alto" => 1181 "Ancho" => 1500 "Tamanyo" => 156660 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Tomografía computarizada de órbitas. Se aprecia el seno maxilar derecho y frontal colapsado, así como ocupación parcial de celdas etmoidales derechas. Desviación del tabique nasal hacia la derecha.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "L. Gómez, E. Fontán, J.C. León, J. Garrido" "autores" => array:4 [ 0 => array:2 [ "nombre" => "L." "apellidos" => "Gómez" ] 1 => array:2 [ "nombre" => "E." "apellidos" => "Fontán" ] 2 => array:2 [ "nombre" => "J.C." "apellidos" => "León" ] 3 => array:2 [ "nombre" => "J." "apellidos" => "Garrido" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2173579414000681" "doi" => "10.1016/j.oftale.2014.05.006" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173579414000681?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365669112004078?idApp=UINPBA00004N" "url" => "/03656691/0000008900000003/v1_201403220243/S0365669112004078/v1_201403220243/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S2173579414000693" "issn" => "21735794" "doi" => "10.1016/j.oftale.2014.05.007" "estado" => "S300" "fechaPublicacion" => "2014-03-01" "aid" => "419" "copyright" => "Sociedad Española de Oftalmología" "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Arch Soc Esp Oftalmol. 2014;89:124-6" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 2396 "formatos" => array:3 [ "EPUB" => 13 "HTML" => 2160 "PDF" => 223 ] ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Short communication</span>" "titulo" => "Intracameral fibrin glue in spontaneous corneal perforation" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "124" "paginaFinal" => "126" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Adhesivo de fibrina intracameral como tratamiento de perforación corneal espontánea" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 996 "Ancho" => 1654 "Tamanyo" => 237490 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Intra-surgery steps: (a) initial condition prior to intervention; (b) paracentesis with 15° blade; (c) introduction of viscoelastic four placing the chamber at the entry of the incision; (d) introduction of Tissucol<span class="elsevierStyleSup">®</span> in anterior chamber to fill in the perforation; (e) placing double amniotic membrane patch with Tissucol<span class="elsevierStyleSup">®</span>; and (f) post-surgery condition.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "J. Celis, D. Mesa, E. Avendaño, F. González-Valle" "autores" => array:4 [ 0 => array:2 [ "nombre" => "J." "apellidos" => "Celis" ] 1 => array:2 [ "nombre" => "D." "apellidos" => "Mesa" ] 2 => array:2 [ "nombre" => "E." "apellidos" => "Avendaño" ] 3 => array:2 [ "nombre" => "F." "apellidos" => "González-Valle" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0365669112004479" "doi" => "10.1016/j.oftal.2012.09.012" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365669112004479?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173579414000693?idApp=UINPBA00004N" "url" => "/21735794/0000008900000003/v1_201407160916/S2173579414000693/v1_201407160916/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S217357941400067X" "issn" => "21735794" "doi" => "10.1016/j.oftale.2014.05.005" "estado" => "S300" "fechaPublicacion" => "2014-03-01" "aid" => "402" "copyright" => "Sociedad Española de Oftalmología" "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Arch Soc Esp Oftalmol. 2014;89:117-20" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 1322 "formatos" => array:3 [ "EPUB" => 13 "HTML" => 1096 "PDF" => 213 ] ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Short communication</span>" "titulo" => "Early treatment of idiopathic vasculitis, aneurysms and neuroretinitis (IRVAN). A case report" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "117" "paginaFinal" => "120" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Tratamiento precoz de vasculitis idiopática, aneurismas y retinitis (IRVAN). A propósito de un caso" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 823 "Ancho" => 931 "Tamanyo" => 93950 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Retinograph of the left eye. Arterial aneurysms in posterior pole. Dense lipidic exudates in macular area following the pathway of large vessels.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "M. Garcia Vilaro, F. Bassaganyas Vilarrassa, J.I. Vela Segarra, J.A. Buil Calvo" "autores" => array:4 [ 0 => array:2 [ "nombre" => "M." "apellidos" => "Garcia Vilaro" ] 1 => array:2 [ "nombre" => "F." "apellidos" => "Bassaganyas Vilarrassa" ] 2 => array:2 [ "nombre" => "J.I." "apellidos" => "Vela Segarra" ] 3 => array:2 [ "nombre" => "J.A." "apellidos" => "Buil Calvo" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0365669112004054" "doi" => "10.1016/j.oftal.2012.07.027" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0365669112004054?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S217357941400067X?idApp=UINPBA00004N" "url" => "/21735794/0000008900000003/v1_201407160916/S217357941400067X/v1_201407160916/en/main.assets" ] "en" => array:20 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Short communication</span>" "titulo" => "Silent sinus syndrome. Clinical case" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "121" "paginaFinal" => "123" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "L. Gómez, E. Fontán, J.C. León, J. Garrido" "autores" => array:4 [ 0 => array:4 [ "nombre" => "L." "apellidos" => "Gómez" "email" => array:1 [ 0 => "lauragomezlopez4@gmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">¿</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "E." "apellidos" => "Fontán" ] 2 => array:2 [ "nombre" => "J.C." "apellidos" => "León" ] 3 => array:2 [ "nombre" => "J." "apellidos" => "Garrido" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Servicio de Oftalmología, Hospital Valle de los Pedroches, Pozoblanco, Córdoba, Spain" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "<span class="elsevierStyleItalic">Corresponding author</span>." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Síndrome del seno silente. Caso clínico" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0020" "etiqueta" => "Fig. 4" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr4.jpeg" "Alto" => 732 "Ancho" => 930 "Tamanyo" => 91801 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Orbit computerized tomography, showing collapsed right and frontal maxillary sinus and partial occupation of right ethmoidal cells. Nasal septum deviated to the right.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Introduction</span><p id="par0005" class="elsevierStylePara elsevierViewall">Patient diagnosed with silent sinus syndrome in the authors’ practice.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Clinic case</span><p id="par0010" class="elsevierStylePara elsevierViewall">Male, 53, without relevant history, who visited the practice due to “sunken right eye” feeling with several months evolution.</p><p id="par0015" class="elsevierStylePara elsevierViewall">Complete ophthalmological exploration was performed which gave a visual acuity of 0.9 in the right eye and 1 in the left eye. Exophthalmometry was 13<span class="elsevierStyleHsp" style=""></span>mm in the right eye and 16<span class="elsevierStyleHsp" style=""></span>mm in the left eye. Increased upper palpebral sulcus was observed in the right eye, with upper palpebral retraction and upper eyelid retraction in downward gaze (<a class="elsevierStyleCrossRefs" href="#fig0005">Figs. 1 and 2</a>). Exploration also revealed enophthalmos and slight lower displacement of said globe (<a class="elsevierStyleCrossRef" href="#fig0015">Fig. 3</a>). The rest of the exploration gave normal results.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0020" class="elsevierStylePara elsevierViewall">CT was performed showing right maxilar antrum and frontal sinus totally occupied as well as partial occupation of anterior right ehtmoidal cells with right deviation of nasal septum (<a class="elsevierStyleCrossRef" href="#fig0020">Fig. 4</a>).</p><elsevierMultimedia ident="fig0020"></elsevierMultimedia><p id="par0025" class="elsevierStylePara elsevierViewall">Silent sinus syndrome was diagnosed and the patient was referred to maxillofacial surgery service where it was decided to defer surgery.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0055">Discussion</span><p id="par0030" class="elsevierStylePara elsevierViewall">The silent sinus syndrome is a little known clinical entity, described as the progressive development of painless facial asymmetry, enophthalmos and hypoglobus secondary to the occupation and chronic atelectasis of the maxillary sinus without nasal or sinus symptoms.</p><p id="par0035" class="elsevierStylePara elsevierViewall">In 1964, Montgomery published the first case of maxillary sinus opacification and collapse causing enophthalmos. However, the silent sinus syndrome was first described by Soparkar et al. in 1994.<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a></p><p id="par0040" class="elsevierStylePara elsevierViewall">The pathogeny of the syndrome is uncertain. According to the current hypotheses, the silent sinus syndrome is caused by maxillary sinus hypoventilation due to the obstruction of the osteo-meatal complex. Progressive gas reabsorption produces negative pressure with subsequent bone remodeling consisting in sinus volume retraction and reduction.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a></p><p id="par0045" class="elsevierStylePara elsevierViewall">This physiopathology is shared by patients with chronic maxillary atelectasis and with silent sinus syndrome. However, the ostial occlusion mode is different. Patients with occlusion due to inflammation and symptomatic rhinosinusitis will be diagnosed with maxillary atelectasis. However, patients with hyper-mobile medial infundibulum wall and without significant nasal sinus symptom history will be related to the silent sinus syndrome.<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1,3</span></a></p><p id="par0050" class="elsevierStylePara elsevierViewall">The changes described above occur in the course of weeks or months. The initial symptom is progressive enophthalmos as a consequence of chronic and progressive maxillary sinus atelectasis. It generally appears between the third and fifth decade of life, without significant differences between sexes.<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a></p><p id="par0055" class="elsevierStylePara elsevierViewall">Clinically, it courses with enophthalmos (spontaneous, with several weeks or months of evolution) and hypoglobus. The presentation symptoms are varied and include orbitary asymmetry, sinking of the upper palpebral orbitary sulcus, palpebral retraction and palpebral delay in downward gaze. Typically, visual acuity is preserved. Diplopia due to globe displacement vis-à-vis the orbit is infrequent.</p><p id="par0060" class="elsevierStylePara elsevierViewall">The above clinical signs are not pathognomic and differential diagnostic must be carried out with chronic sinusitis, osteomyelitis, malign infiltration, orbit traumatism, Wegener granulomatosis and systemic disease (sclerodermia).<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">1</span></a></p><p id="par0065" class="elsevierStylePara elsevierViewall">Even though the suspicion is clinical, diagnosis is achieved by means of radiology. CT is the reference test, the most characteristic finding being internal retraction of sinus walls. The infundibulum is invariably occupied and the maxillary sinus opacified. The ocular globe and orbit contents are caudally displaced due to orbit floor depression.<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a></p><p id="par0070" class="elsevierStylePara elsevierViewall">Treatment is divided in nasosinusal and orbitary. The former includes correcting ostial occlusion and effective evacuation decompression. The treatment can be applied by means of nasosinusal endoscopic surgery with uncinectomy and maxillary antrostomy or with a Cadwell-Luc approach. In patients with significant diplopia or aesthetic deformity, surgical reconstruction of the orbitary floor is performed by means of subperiostium graft, which can be carried out at the same time or after nasosinus surgery.<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a></p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0060">Conflict of interests</span><p id="par0075" class="elsevierStylePara elsevierViewall">No conflict of interests has been declared by the authors.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:9 [ 0 => array:2 [ "identificador" => "xres352629" "titulo" => array:3 [ 0 => "Abstract" 1 => "Clinical case" 2 => "Discussion" ] ] 1 => array:2 [ "identificador" => "xpalclavsec334092" "titulo" => "Keywords" ] 2 => array:2 [ "identificador" => "xres352628" "titulo" => array:3 [ 0 => "Resumen" 1 => "Caso clínico" 2 => "Discusión" ] ] 3 => array:2 [ "identificador" => "xpalclavsec334091" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Introduction" ] 5 => array:2 [ "identificador" => "sec0010" "titulo" => "Clinic case" ] 6 => array:2 [ "identificador" => "sec0015" "titulo" => "Discussion" ] 7 => array:2 [ "identificador" => "sec0020" "titulo" => "Conflict of interests" ] 8 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2012-05-08" "fechaAceptado" => "2012-07-20" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec334092" "palabras" => array:5 [ 0 => "Enophtalmos" 1 => "Sinusitis" 2 => "Hypoglobus" 3 => "Silent sinus syndrome" 4 => "Palpebral fissure" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec334091" "palabras" => array:5 [ 0 => "Enoftalmos" 1 => "Sinusitis" 2 => "Hipoglobo" 3 => "Síndrome del seno silente" 4 => "Surco palpebral" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span class="elsevierStyleSectionTitle" id="sect0010">Clinical case</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">A 53-year-old man presented with a progressive enophthalmos without any sinus or nasal symptoms. There was no history of a trauma. The ophthalmology examination showed enophtalmos and hypoblobus. The computerized tomography (CT) showed a collapsed maxillary and frontal sinus and a laterally nasal tabique desviation that led us to the diagnosis.</p> <span class="elsevierStyleSectionTitle" id="sect0015">Discussion</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">The clinical features of silent sinus syndrome are described, as well as the need to distinguish it from maxillary sinusitis.</p>" ] "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<span class="elsevierStyleSectionTitle" id="sect0025">Caso clínico</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Varón de 53 años que acude a la consulta por enoftalmos en ojo derecho (OD) progresivo sin sintomatología asociada. Ausencia de antecedente traumático. En la exploración se observa un enoftalmos y leve desplazamiento inferior del globo derecho. En el TC se aprecia una ocupación total del antro maxilar derecho y del seno frontal así como una desviación del tabique nasal hacia la derecha, lo que confirma el diagnóstico de síndrome del seno silente.</p> <span class="elsevierStyleSectionTitle" id="sect0030">Discusión</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Se comentan las características más importantes del síndrome del seno silente, una enfermedad poco conocida que no debe confundirse con la sinusitis maxilar.</p>" ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Gómez L, Fontán E, León JC, Garrido J. Síndrome del seno silente. Caso clínico. Arch Soc Esp Oftalmol. 2014;89:121–123.</p>" ] ] "multimedia" => array:4 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Fig. 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 731 "Ancho" => 930 "Tamanyo" => 165036 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Upper palpebral retraction of the right eye.</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Fig. 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 698 "Ancho" => 930 "Tamanyo" => 132466 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Upper palpebral delay of the right eye in downward gaze and sinking of upper palpebral sulcus.</p>" ] ] 2 => array:7 [ "identificador" => "fig0015" "etiqueta" => "Fig. 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 698 "Ancho" => 930 "Tamanyo" => 147686 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Right side enophthalmos, slight lower displacement and fascial asymmetry.</p>" ] ] 3 => array:7 [ "identificador" => "fig0020" "etiqueta" => "Fig. 4" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr4.jpeg" "Alto" => 732 "Ancho" => 930 "Tamanyo" => 91801 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Orbit computerized tomography, showing collapsed right and frontal maxillary sinus and partial occupation of right ethmoidal cells. Nasal septum deviated to the right.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:5 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Síndrome del seno silente" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "M. Borrás" 1 => "V. Palomar" 2 => "J. Soteras" 3 => "J.C. Fortuna" 4 => "V. Palomar" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Acta Otorrinolaringol Esp" "fecha" => "2007" "volumen" => "58" "paginaInicial" => "491" "paginaFinal" => "493" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18082081" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Solución del caso 12, Síndrome del seno silente" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "C. Leiva-Salinas" 1 => "P.M. Som" 2 => "L. Flors" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.rx.2009.01.018" "Revista" => array:6 [ "tituloSerie" => "Radiología" "fecha" => "2009" "volumen" => "51" "paginaInicial" => "625" "paginaFinal" => "627" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19942038" "web" => "Medline" ] ] ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Hiplopasia del seno maxilar. Caso clínico" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "A. García de Hombre" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Rev Otorrinolaringol cir cab-cue" "fecha" => "2002" "volumen" => "62" "paginaInicial" => "42" "paginaFinal" => "46" ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Síndrome del seno silente, una causa infrecuente de enoftalmos" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "B.F. Sánchez-Dalmau" 1 => "L. Pascual" 2 => "X. Lao" 3 => "J. Maiz" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Arch Soc Esp Oftalmol" "fecha" => "2007" "volumen" => "82" "paginaInicial" => "125" "paginaFinal" => "128" ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Enoftalmos en paciente con antecedente de traumatismo facial" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "G. Amengual" 1 => "H. Sarasibar" 2 => "A. Estremera" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:4 [ "tituloSerie" => "Med Balear" "fecha" => "2006" "paginaInicial" => "34" "paginaFinal" => "35" ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/21735794/0000008900000003/v1_201407160916/S2173579414000681/v1_201407160916/en/main.assets" "Apartado" => array:4 [ "identificador" => "5812" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Short communications" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/21735794/0000008900000003/v1_201407160916/S2173579414000681/v1_201407160916/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2173579414000681?idApp=UINPBA00004N" ]
| Year/Month | Html | Total | |
|---|---|---|---|
| 2018 March | 1 | 0 | 1 |
| 2018 February | 20 | 1 | 21 |
| 2018 January | 47 | 2 | 49 |
| 2017 December | 29 | 0 | 29 |
| 2017 November | 20 | 0 | 20 |
| 2017 October | 22 | 2 | 24 |
| 2017 September | 26 | 2 | 28 |
| 2017 August | 22 | 1 | 23 |
| 2017 July | 32 | 5 | 37 |
| 2017 June | 39 | 8 | 47 |
| 2017 May | 65 | 2 | 67 |
| 2017 April | 35 | 8 | 43 |
| 2017 March | 45 | 41 | 86 |
| 2017 February | 54 | 4 | 58 |
| 2017 January | 48 | 0 | 48 |
| 2016 December | 71 | 7 | 78 |
| 2016 November | 53 | 3 | 56 |
| 2016 October | 68 | 2 | 70 |
| 2016 September | 61 | 4 | 65 |
| 2016 August | 57 | 6 | 63 |
| 2016 July | 36 | 3 | 39 |
| 2016 June | 36 | 1 | 37 |
| 2016 May | 45 | 16 | 61 |
| 2016 April | 38 | 1 | 39 |
| 2016 March | 47 | 8 | 55 |
| 2016 February | 43 | 7 | 50 |
| 2016 January | 40 | 9 | 49 |
| 2015 December | 40 | 7 | 47 |
| 2015 November | 44 | 2 | 46 |
| 2015 October | 55 | 6 | 61 |
| 2015 September | 43 | 8 | 51 |
| 2015 August | 66 | 2 | 68 |
| 2015 July | 90 | 5 | 95 |
| 2015 June | 47 | 0 | 47 |
| 2015 May | 54 | 3 | 57 |
| 2015 April | 31 | 8 | 39 |
| 2015 March | 19 | 6 | 25 |
| 2015 February | 24 | 0 | 24 |
| 2015 January | 16 | 7 | 23 |
| 2014 December | 30 | 6 | 36 |
| 2014 November | 21 | 7 | 28 |
| 2014 October | 29 | 12 | 41 |
| 2014 September | 58 | 11 | 69 |
| 2014 August | 4 | 2 | 6 |
Show all
