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Silent sinus syndrome SSS is a disease in which the natural orifice of the maxillary sinus becomes obstructed and the pressure in the sinus becomes negative due to hypoventilation, causing asymptomatic enophthalmos and hypoglobus associated with inward depression of the maxillary sinus and thinning of the bones. We encountered one patient with obstruction of the natural orifice of the maxillary sinus by an inverted papilloma of the paranasal cavity and pterygopalatine fossa tumor with inward depression of the maxillary sinus wall, in whom we suspected SSS. For treatment, we performed endoscopic resection of the paranasal cavity tumor and opened the maxillary sinus. Following the operation, the inward depression of the maxillary sinus improved and bone regeneration was also observed. We need to bear in mind the possibiltity of SSS in cases presenting with obstruction of the natural orifice of the maxillary sinus and caudal deviation of the inferior wall of the orbit and expansion of the pterygopalatine fossa associated with inward depression of the maxillary sinus. Moreover, in the event that SSS is confirmed, opening of the maxillary sinus can improve both the symptoms and findings.

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