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.
Almost all patient tend to be asymptomatic, according to one study 2. Patients will have an absence of prior trauma.
There is some speculation that it might be caused by a hyperaerated ethmoid 1.
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.
On imaging consider:
- Recognizing this has implications in planning sinus procedures such as functional endoscopic sinus surgery (FESS).
- 1. Moulin G, Dessi P, Chagnaud C, Bartoli JM, Vignoli P, Gaubert JY, Castro F, Delannoy L, Sibartie A. Dehiscence of the lamina papyracea of the ethmoid bone: CT findings. (1994) AJNR. American journal of neuroradiology. 15 (1): 151-3. Pubmed
- 2. Kitaguchi Y, Takahashi Y, Mupas-Uy J, Kakizaki H. Characteristics of Dehiscence of Lamina Papyracea Found on Computed Tomography Before Orbital and Endoscopic Endonasal Surgeries. (2016) The Journal of craniofacial surgery. 27 (7): e662-e665. doi:10.1097/SCS.0000000000003005 - Pubmed