Over the years, I've suffered from breathing problems (unable to breathe out of one side of my nose and the side changes), and my eyes have become increasingly "sunken." I got hit in the face during sports during childhood so I don't know if this is relevant. It's clear that it is the orbital position, rather than simply a lack of fat. How would I go about trying to resolve this? Should I see an ear, nose, and throat doctor to look at my sinuses, or should I go to an eye specialist/surgeon?
Options For Fixing Bilateral Enopthalmos And Breathing Problems?
Doctor Answers 2
Treating enophthalmos and breathing problems
Enophthalmos and breathing problems are two totally separate issues and are typically treated by two different subsets of physicians.
Enophthalmos is treated by an oculoplastic surgeon who deals with eyelid oculoplastic and reconstructive surgery. Any trama to the orbits can be dealt with by this type of specialist.
A breathing problem out of the nose is typically due to a deviated septum and is best treated by an ear, nose, and throat doctor. If there are chronic underlying sinus infections, then consideration for a CAT scan of the sinuses can be made at the time of the examination by the ear, nose, and throat doctor.
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I would strongly recommend that you see a facial plastic surgeon or an Ear, Nose and Throat surgeon.
There is a well described syndrome called the silent sinus syndrome. It occurs when sinus airway to the maxillary sinus, which lies under the floor of the orbit closes. Negative pressure develops in the sinus and over time the floor of the orbit deforms. This causes the soft tissue contents of the orbit around the eye to sink. The affected eye looks smaller and enophthalmic. This is usually on just one side but there is no reason why it could not effect both sides. A CT scan and consultation with the ENT surgeon will confirm the diagnosis. Surgery is performed in these situations to reopen the sinus and if necessary the orbital floor is repaired.
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