Case Report Repetitive Sinus-Related Symptoms May Accelerate the Progression of Chronic Maxillary Atelectasis Shu Kikuta, Kyohei Horikiri, Kaori Kanaya, Ryoji Kagoya, Kenji Kondo, and Tatsuya Yamasoba Department of Otolaryngology, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan Correspondence should be addressed to Shu Kikuta; sh-kiku@m.u-tokyo.ac.jp Received 22 March 2017; Accepted 5 June 2017; Published 3 July 2017 Academic Editor: Marco Berlucchi Copyright © 2017 Shu Kikuta et al. is is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Chronic maxillary atelectasis (CMA) is characterized by a progressive decrease in maxillary sinus volume. e factors that promote the stage progression of CMA remain poorly understood. Here, we describe the time course of anatomical changes in a 40-year-old woman with stage II CMA that progressed to stage III disease. She did not show stage progression until she started to develop repetitive sinus-related symptoms. e stage progression was characterized by ocular symptoms. e repetitive inflammatory episodes may have increased the negative pressure in the affected sinus and weakened the bone walls, thereby promoting stage progression. us, a history of repetitive sinus-related symptoms may be a risk factor for stage progression in CMA. 1. Introduction Chronic maxillary atelectasis (CMA) is characterized by a persistent and progressive decrease in the maxillary sinus volume and occlusion of the infundibulum as a result of inward bowing of the antral walls [1–4]. CMA is categorized into three stages on the basis of the degree of sinus wall deformation. Stage I is characterized by a lateralized max- illary fontanel (membranous deformity); stage II is defined as inward bowing of one or more of the osseous walls (bone deformity); and stage III is characterized by enophthalmos, hypoglobus, and/or midfacial deformity (clinical deformity) [1, 5]. Although several authors have previously reported cases of patients with CMA [2, 6–9], they only described the condition at one time point. We speculated that if we followed CMA patients as they progressed through the various stages of CMA, we might be able to identify factors that predict stage progression. We report here the case of a patient with stage II CMA who did not exhibit progression until she developed repetitive sinus-related symptoms. is development might be associated with the progression of the disease to stage III CMA. Our observations suggest that a history of repetitive sinus-related symptoms may be a risk factor for stage progression in CMA. 2. Case Presentation A 40-year-old Hungarian woman suddenly noticed upgaze diplopia and right cheek compression when she woke up in the morning. Shortly thereaſter, she consulted an ophthal- mologist and then an otolaryngologist in another hospital. e investigations suggested that she had a carcinoma in the pterygopalatine fossa on the right side. erefore, the otolaryngologist referred the patient to our institution for further examination. Examination of the facial appearance of the patient indicated more deepening of the right upper eyelid sulcus than the leſt eyelid sulcus (Figure 1(a)). An endoscopic examination showed that the right uncinate process could not be clearly detected and seemed to adhere to the medial wall of the maxillary sinus (Figure 1(b)). Computed tomography (CT) imaging then revealed inferior bowing of the floor of the orbit into the right maxillary sinus, lateral driſting of the right uncinate process into close contact with the floor of the orbit, and partial opacification of the maxillary sinus and anterior ethmoidal cells (Figure 1(c)). Magnetic resonance imaging (MRI) findings confirmed prolapse of the inferior inward retraction of the posterior, lateral, and medial walls of the maxillary sinus on the right side (Figure 1(d)). e patient had not experienced any trauma and did not have Hindawi Case Reports in Otolaryngology Volume 2017, Article ID 4296195, 5 pages https://doi.org/10.1155/2017/4296195