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.
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Clinical presentation
Almost all patients tend to be asymptomatic, according to one study 2. Patients will have an absence of prior trauma.
Pathology
There is some speculation that it might be caused by a hyperaerated ethmoid 1.
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)