Repetitive Sinus-Related Symptoms May Accelerate the Progression of Chronic Maxillary Atelectasis

Figure 2

Magnetic resonance images taken 3 and 2 years before the development of ocular manifestations. (a) Magnetic resonance image (MRI) findings: (A) the T2 axial view of MRI 3 years before the ocular presentation; (B) the T2 axial view of MRI 2 years before the ocular presentation. Both images show that the medial wall of the right maxillary sinus is deviated compared to the medial wall of the left maxillary sinus. Similar anatomical changes are observed. Thus, 3 and 2 years before ocular manifestations appeared, the distances from the center line to the most deviated medial wall of the right maxillary sinus were 19 and 19 mm (red lines), respectively. By contrast, the distances from the center line to the most deviated medial wall of the left (unaffected) maxillary sinus were 11.5 and 11 mm (blue lines), respectively. Both situations indicate stage II disease. (b) Time course of the CMA patient. The first MRI was performed 3 years before ocular symptom presentation (A). The second MRI was performed 2 years before ocular symptom presentation (B). The patient did not present with any sinusitis-related symptoms before or at the first (A) and the second (B) MRI. However, in the 2 years following the second MRI, the patient frequently presented with sinus-related symptoms. At the end of that period, the patient was diagnosed with stage III disease.

(a)

(b)