Dehiszenz der medialen Orbitawand
An additional
challenge for head and neck radiologists: anatomic variants posing a surgical risk – a pictorial review. Orbital wall dehiscence. The thin lamina papyracea is focally interrupted on the left side (arrows), where a small amount of extraconal fat tissue (asterisk) protrudes into the ethmoid labyrinth
Lamina
papyracea dehiscence • Lamina papyracea dehiscence - Ganzer Fall bei Radiopaedia
Lamina
papyracea dehiscence • Lamina papyracea and orbital floor dehiscence - Ganzer Fall bei Radiopaedia
Lamina
papyracea dehiscence • Lamina papyracea dehiscence - Ganzer Fall bei Radiopaedia
Dehiscence of the lamina papyracea is an anomaly of the paranasal sinuses represented by a defect of the medial orbital wall. It is thought to be a benign congenital variant of no clinical significance.
Clinical presentation
Almost all patient tend to be asymptomatic, according to one study . Patients will have an absence of prior trauma.
Pathology
There is some speculation that it might be caused by a hyperaerated ethmoid .
Radiographic features
CT / MRI
Dehiscence is usually characterized by protrusion of orbital fat through a defect in the anterior ethmoid bone. The posterior limit of the dehiscence tends to be the basal lamella while the anterior limit may vary.
Differential diagnosis
On imaging consider:
- sequela of an old medial orbital blowout fracture.
Practical points
- Recognizing this has implications in planning sinus procedures such as functional endoscopic sinus surgery (FESS).
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