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Missed Dehiscence of Lamina Papyracea by Radiologists: Orbital Herniation Mimicking Sinusitis and Harboring Potential Complications
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  • Saud Alromaih,
  • Sahar Almutairi,
  • Ali Alrashidi,
  • Nasser Mohammed Marran,
  • Malek Alrobaian,
  • Saad Alsaleh,
  • Ahmad Alroqi,
  • Mohammad Aloulah,
  • Abdulaziz Alrasheed,
  • Ghassan Alokby,
  • Omar Abu Suliman ,
  • ABDULLAH BAHAKIM
Saud Alromaih
King Saud University College of Medicine

Corresponding Author:[email protected]

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Sahar Almutairi
Dar Al Uloom University College of Medicine
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Ali Alrashidi
King Saud University College of Medicine
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Nasser Mohammed Marran
King Faisal Specialist Hospital and Research Centre Oncology Centre
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Malek Alrobaian
King Saud bin Abdulaziz University for Health Sciences College of Medicine
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Saad Alsaleh
King Saud University College of Medicine
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Ahmad Alroqi
King Saud University College of Medicine
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Mohammad Aloulah
King Saud University College of Medicine
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Abdulaziz Alrasheed
King Saud University College of Medicine
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Ghassan Alokby
King Faisal Specialist Hospital and Research Centre Oncology Centre
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Omar Abu Suliman
King Abdullah Medical City
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ABDULLAH BAHAKIM
King Abdulaziz University Jeddah Teachers College
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Abstract

Introduction: Functional endoscopic sinus surgery (FESS) has become the gold standard for treating chronic rhinosinusitis (CRS), and it is regarded as a relatively safe and effective technique. Orbital complications of FESS have been reported for many years owing to the close anatomical relationship between the paranasal sinuses and the orbit. Accidental injury of the lamina papyracea (LP) during FESS, was described in up to 5% of cases. Preventing complications begins with preoperative planning and careful review of computed tomographic (CT) scans. Methods: This was a multicentric national survey to report any case of lamina papyracea defect (LPD) that was not reported by radiologists. Multiple rhinologists from different provinces of Saudi Arabia (SA) were invited to report any patient with such an incidence in the last two years. patient-specific data were all included in this study. Results: The data of 16 patients, 11 males and 5 females, were reviewed retrospectively. The median age at diagnosis was 37.4 years. The right side is the most prevalent location of LPD (8 patients, 50%), despite the fact that most cases (75%) had no history of trauma or sinus surgery. Five patients had left-side LPDs and three had bilateral LPDs. Conclusion: Injury to the LP is a well-known avoidable complication of FESS. Careful and attentive review of CT scan images pre-operatively and by the operating surgeon is of utmost importance. This should always include the integrity and configuration of the medial orbital wall and LP without depending on the report of CT scans.