Vol.96 No.3 contentsPRACTICA OTO-RHINO-LARYNGOLOGICA
Vol. 96 No. 3 March 2003
CT Evaluation of Medial Protrusion of
the Lamina Papyracea
Kouichi Abe
(Jichi Medical School)
Kousuke Ishii, Masanori Yamamoto and Keiju Tsubaki
(Omiya Medical Center, Jichi Medical School)
The frequency, location and gender difference of the medial protrusion of the lamina papyracea toward the ethmoid sinus were evaluated in 522 patients who underwent CT of the paranasal sinus region at our institution between January 1999 and January 2002. The area of interest was the nose and paranasal sinuses in 295 patients, auditory organ in 190 patients and maxillofacial area in 37 patients. The lamina papyracea was clearly identified in all the patients. Patients with a past history of paranasal sinus surgery and those with injuries in the lamina papyracea were excluded from the study. The patients consisted of 283 males and 239 females aged between 6 and 94 years. Twenty-nine patients were younger than 20 years old. Axial slices were taken in most cases. Medial protrusion was judged to be positive in cases where the lamina papyracea evidently deviated toward the ethmoid sinus on CT and the CT value of the protruded area was identical to that of the orbital fat.
Medial protrusion of the lamina papyracea was positive in 4 males and 2 females with a frequency of 1.15％. All the 6 patients were older than 20 years old. The protrusion was located in the anterior ethmoid in 2 patients, middle ethmoid in 3 patients and entire ethmoid area in 1 patient whose ethmoid sinuses were poorly developed. The protrusion was also located on the right side in 4 patients and on the left side in 2. Bilateral protrusion was not observed.
It has been reported that the frequency of medial protrusion of the lamina papyracea is about 1％. CT is an essential examination before surgery of the nose and paranasal sinuses. It is important to preoperatively evaluate the anatomical relation of critical structures including the lamina papyracea.
Key words : lamina papyracea, protrusion, endonasal sinus surgery