Spontaneous enophthalmos unrelated to trauma or surgery is rare. The term ‘silent sinus syndrome’ has been used to describe this process where, in particular,there is an absence of any sino-nasal symptoms. The enophthalmos and hypoglobus that occurs inthese subjects is caused by atelectasis of the maxillary antrum, which itself appears to be due to chronic maxillary hypoventilation. We report a case of silent sinus syndrome that arose following insertion of a nasogastric tube. Whilst acute paranasal sinusitis is a well-described sequela of nasal intubation, this association with a rare, and as yet unexplained, phenomenon may go some way to explain its aetiology.