Nevertheless, the severity of narcosis is unpredictable and it can be fatal while diving, as the result of illogical behavior in a dangerous environment.Tests have shown that all divers are affected by nitrogen narcosis, though some experience lesser effects than others. Even though it is possible that some divers can manage better than others because of learning to cope with the subjective impairment, the underlying behavioral effects remain. These effects are particularly dangerous because a diver may feel they are not experiencing narcosis, yet still be affected by it. History
French researcher Victor T. Junod was the first to describe symptoms of narcosis in 1834, noting "the functions of the brain are activated, imagination is lively, thoughts have a peculiar charm and, in some persons, symptoms of intoxication are present." Junod suggested that narcosis resulted from pressure causing increased blood flow and hence stimulating nerve centers. Walter Moxon (1836–1886), a prominent Victorian physician, hypothesized in 1881 that pressure forced blood to inaccessible parts of the body and the stagnant blood then resulted in emotional changes. The first report of anesthetic potency being related to lipid solubility was published by Hans H. Meyer in 1899, entitled Zur Theorie der Alkoholnarkose. Two years later a similar theory was published independently by Charles Ernest Overton. What became known as the Meyer-Overton hypothesis may be illustrated by a graph comparing narcotic potency with solubility in oil. In 1939, Albert R. Behnke and O. D. Yarborough demonstrated that gases other than nitrogen also could cause narcosis.
The distinguishing factor is that in silent sinus syndrome, there is an absence of sinusitis symptoms. To be clear, chronic maxillary sinusitis may be a primary causitive factor in a significant number of silent sinus syndrome cases, it just may be asymptomatic. Silent sinus syndrome also must be distinguished from maxillary sinus hypoplasia, which is congenital. Treatment
Silent sinus syndrome is usually treated with surgery. The first stage involves restoring sinus function, most often by performing an endoscopic uncinectomy (removal of uncinate process) and maxillary antrostomy. The second stage, if needed, involves reconstruction of the orbital floor. While some clinics perform the two stages simultaneously, most authorities recommend waiting a minimum of 6 or as many as 18 months, as spontaneous remodeling of the orbital floor after the sinus repair will occur in many if not most cases. Any prolapsed contents (such as those from the orbit) must be put back in place, though this is an rare occurrence in an already rare syndrome. If the inferior oblique muscle is damaged, it may be partially removed (known as myectomy). Mucus and secretions must be drained from the sinus. Earlier treatment has better outcomes. Epidemiology
Silent sinus syndrome is fairly rare. It can occur at any age, but is slightly more common in middle-aged people. It occurs equally in sinuses on each side of the face. History
Silent sinus syndrome was first described in 1964. References
Bibliography
Illner A, Davidson HC, Harnsberger HR, Hoffman J (2002). "The silent sinus syndrome: clinical and radiographic findings". AJR Am J Roentgenol. 178 (2): 503–6. doi:10.2214/ajr.178.2.1780503.