Progressive enophtalmos secondary to the maxillary sinus opacification is known as silent sinus syndrome. Silent sinus syndrome is a rare clinical entity that progresses gradually due to the osteomeatal complex obstruction. Ostiomeatal blockage due to the damage of this complex is the most possible cause of maxillary sinus atelectasis.

We present Three patients developed chronic silent sinus syndrome following nasal surgery. There has been only one prior report of silent sinus syndrome presenting after nasal surgery. Despite of this prior report, silent sinus syndrome in our four patients is a first report of delayed silent sinus syndrome following nasal surgery that all were developed more than one year after procedure.

Lateral displacement of the end part of middle turbinate results in obstruction of the ostiomeatal and accumulation of secretions in closed sinus cavity. All of the patients had nasal dressing after surgery.

Our hypothesis is that the nasal dressing following nasal surgery may lead to lateralization of the end of middle turbinate. Silent sinus syndrome and enophthalmus can be a potential missed complication of septorhinoplasty which may present several years after surgery.