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Clinical Note |

Boundary Issues:  A Case of Nontraumatic Bilateral Dehiscence of the Lamina Papyracea

Matthew J. Seeley, MBChB; David R. Waterhouse, MBChB; Subaschandra Shetty, MBBS, MS(ENT); Jeremy S. Gathercole, MBBS, FRACS; Christopher J. Seeley, MBChB, FRACS
Arch Otolaryngol Head Neck Surg. 2010;136(1):88-89. doi:10.1001/archoto.2009.196.
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Functional endoscopic sinus surgery is now the standard intervention for recalcitrant chronic paranasal rhinosinusitis. Computed tomography (CT) is the usual modality for preoperative investigation of the paranasal sinuses. Imaging provides information about anatomical variations in the area and may also give some information about disease severity. Dehiscence of the lamina papyracea, with herniation of the orbital contents into the ethmoid sinuses, can be a consequence of facial trauma or a nontraumatic anatomical variation. It may involve protrusion of orbital contents through an adjacent defect or a medial protrusion of the lamina papyracea itself.

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Figure 1.

Coronal bone-window computed tomogram of the paranasal sinuses at the level of the anterior ethmoid sinus. The computed tomogram shows bilateral dehiscence with medial protrusion of the orbital contents at the midpoint of the lamina papyracea.

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Figure 2.

Coronal bone-window computed tomogram showing the posterior extent of bilateral lamina papyracea dehiscence and associated herniation of the orbital contents at the level of the ethmoid artery.

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