Computerized tomography imaging of the bone dehensances in the orbital medial wall and evaluation of terminological

Abstract

The bone structures forming the orbital medial wall are the lateral or orbital side of the lacrimal bone, the frontal process of the maxillary bone, the lamina papyracea of the ethmoid bone, and the corpus of the sphenoid bone. The paranasal sinuses (PNS) are a region with many variations. Bone structures are very thin and dehiscences are common [ONODI 1909].

In this study, we aimed to investigate the frequency, age and sex relationship of patients with bone continuity in pati- ents who underwent standard PNS CT examination, to reveal the efficacy of computed tomography for the detection of bone defects in the orbital medial wall, and to highlight the terminological differences in this literature. Computed tomography (CT) of the paranasal sinuses provides detailed information about sinonasal anatomy and variations.

The shots were made with GE brand IQ model 32 detector spiral device,  using 130 kV voltage and 80-120 mAn  values according to bone protocol. In 115 patients (59 males, 56 females), 230 orbital medial walls revealed 71 (30.9%) bone defects (34 males, 37 females). In 8 of these cases (4 males, 4 females), herniation of orbital fat tissue into the ethmoid sinus was present.

In our study, bone loss without herniation was found to be higher than mentioned in the literature. It was thought that low density bone structure below a certain thickness could not be differentiated in density by CT examinations, and that the findings could be confirmed by microdissection of the samples with dehiscence in the CT specimens.

As a result, we believe that radiologists should investigate the existence of these dehiscences whether or not there is a herniation in the PNS CT evaluation, and that more attention should be paid to the correct use of the words herniation and dehiscence / Gap in interpretations and studies.