OBJECTIVE: Relate a silent sinus syndrome case with his atypical symptoms and treatment adopted. The silent sinus syndrome is characterized by chronic atelectasis of the maxillary sinus. An important manifestation is the presence of ocular asymmetry without visual compromise. The cause remains unknown, and the treatment is eminently surgical. CASE REPORT: A 29-year-old man presented with pressure in the right hemiface, with onset seven years ago, without more symptoms or previous investigations. Signs of sinus disease were recorded without oroscopy or otoscopy alterations. Held paranasals computerized tomography, demonstrating reduction of right maxillary sinus diameter with right maxillary sinus ostium obliteration CONCLUSION: The silent sinus syndrome is an entity that must be recognize by the otorhinolaryngologist, with endonasal endoscopic surgery the ideal approach to treatment.