Relationship Between Lacrimal Bone Thickness and Lacrimal Sac in Chronic Dacryocystitis

ABSTRACT Objective To compare the results of conventional nasal endoscopic dacryocystorhinostomy (DCR) and inferior nasal endoscopic DCR in Study cases of idiopathic chronic dacryocystitis. Materials and methods Forty patients diagnosed with idiopathic chronic dacryocystitis were divided into two groups alternately. After relevant investigations, they were subjected for endoscopic DCR by two techniques. Twenty patients underwent conventional endoscopic DCR and 20 underwent inferior endoscopic DCR under transoral pterygopalatine block and topical lignocaine (4%) with adrenaline 1:2,000. After 3 months of follow-up in the outpatient department, nasal endoscopy along with fluorescein dye disappearance test (FDDT) at 10 minutes was done. Results Ninety-five percent (19/20) of patients undergoing conventional endoscopic DCR and 90% (18/20) of patients undergoing inferior endoscopic DCR were found to have patent anatomical fistula. On FDDT, nasal endoscopy after 10 minutes revealed 84% (16/19) in group I and 94.4% (17/18) in group II with fluorescein in nasal cavity. Conclusion Present study concludes the importance of bony, tendinous, and muscular support of lacrimal sac in physiological lacrimal pump functioning and advantage of relatively new technique of inferior endoscopic DCR. Inferior endoscopic DCR is associated with less operative time as well as less local complications. How to cite this article Thakur K, Kashyap A, Negi S, Chauhan PL. Anatomical and Functional Evaluation of Conventional vs Inferior Endoscopic Dacryocystorhinostomy in Study Cases of Idiopathic Chronic Dacryocystitis. Clin Rhinol An Int J 2017;10(2):86-90.

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Primary small B cell non-Hodgkin Lymphoma of the Lacrimal Sac Upon Chronic Dacryocystitis

Medical Science and Discovery ◽

10.17546/msd.19842 ◽

2016 ◽

Vol 3 (7) ◽

pp. 290

Author(s):

Murat Gumussoy ◽

Sinan Uluyol ◽

Ulku Kucuk ◽

Gokhan Kurtoglu ◽

Tolga Kandogan ◽

...

Keyword(s):

B Cell ◽

Hodgkin Lymphoma ◽

Lacrimal Sac ◽

Non Hodgkin Lymphoma ◽

Chronic Dacryocystitis

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Ectopic lacrimal gland in the lacrimal sac mimicking tumour: literature review

BMJ Case Reports ◽

10.1136/bcr-2020-235187 ◽

2020 ◽

Vol 13 (7) ◽

pp. e235187

Author(s):

Athanasios Saratziotis ◽

Claudia Zanotti ◽

Maria Baldovin ◽

Enzo Emanuelli

Keyword(s):

Lacrimal Gland ◽

Histopathological Examination ◽

Drainage System ◽

Surgical Excision ◽

Complete Recovery ◽

Postoperative Recovery ◽

Endoscopic Approach ◽

Lacrimal Sac ◽

Chronic Dacryocystitis ◽

Mri Scans

An 80-year-old man referred with repeated episode of dacryocystitis from the left lacrimal drainage system and palpable swelling. For many years, he has being presented with epiphora unilaterally with chronic dacryocystitis. Investigations with dye-test revealed subocclusion of the natural passage of the tears, and CT and MRI scans revealed solid mass in the lacrimal sac. The lacrimal sac was opened by endonasal endoscopic approach, the sacral mass was identified and completely removed. The histopathological examination showed lacrimal gland in ectopic position. Patient followed for 18 months with complete recovery of symptoms. In our differential diagnosis, the ectopic lacrimal gland is also identified, when a mass in the lacrimal sac and duct is present. Successful surgical excision required considerable multidisciplinary teamwork between ophtalmologist–ENT (Otolaryngologist) and radiologist. Endonasal endoscopic approach is perfectly safe with direct control and ensures a smooth postoperative recovery.

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Intraoperative Identification of Lacrimal Sac by Means of Methylene Blue

Revista de Chimie ◽

10.37358/rc.18.1.6068 ◽

2018 ◽

Vol 69 (1) ◽

pp. 172-174

Author(s):

Camelia Margareta Bogdanici ◽

Claudia Florida Costea ◽

Gabriela Dimitriu ◽

Madalina Adriana Chihaia ◽

Alexandru Carauleanu ◽

...

Keyword(s):

Methylene Blue ◽

Clinical Study ◽

Pulmonary Fibrosis ◽

Elderly Patients ◽

Female Patient ◽

Lower Limb ◽

Histopathological Examination ◽

Lacrimal Sac ◽

The Past ◽

Chronic Dacryocystitis

Methylene blue (MB) has many uses in medicine, being applied as a treatment for infections, malaria, methemoglobinemia, as a dye for diagnosis and for staining of cells, tissues and bacteria. In elderly patients with associated high anaesthetic risk, dacryocystectomy is an alternative to dacryocystorhinostomy. This is an observational clinical study for two cases of chronic dacryocystitis where dacryocystectomy combined with MB (1%) staining of lacrimal sac was performed. Case no.1 - an 81-year old female patient with arterial hypertension, atherosclerosis, pulmonary fibrosis, and lower limb varices complainted of recurrent epiphora, muco-purulent secretions in both eyes, inflammatory oedema of the left perisacular region for the past 6 months. Case no. 2 - a 74-year old female patient with hypothyroidism suffered from chronic epiphora in the left eye with a purple-red oedema of the inferior eyelid and perisacular region. Symptoms reoccurred in the last 10 months despite topical and systemic therapy with antibiotics and anti-inflamatory drugs. Dacryocystectomy was performed under local anaesthesia in both patients. MB (1%) was used to irrigate the lacrimal sac in order to facilitate its localisation, dissection and excision. Results: Case no.1. Ectopic lacrimal sac. Case no.2. Enlarged lacrimal sac (7.5/14 mm). The histopathological examination revealed a trachomatous dacryocystitis, respectively a chronic non-suppurative non-granulomatous dacryocystitis. Their postoperative evolution was without complications, except for a mild epiphora. In conclusion, dacryocystectomy appears to be a less traumatising alternative to dacryocystorhinostomy. The staining of the lacrimal sac with MB (1%) in dacryocystectomy facilitates its identification and dissection, especially when it is ectopic.

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Endoscopic Endonasal Dacryocystorhinostomy With a Novel Lacrimal Ostium Stent in Chronic Dacryocystitis Cases With Small Lacrimal Sac

Journal of Craniofacial Surgery ◽

10.1097/scs.0000000000006359 ◽

2020 ◽

Vol Publish Ahead of Print ◽

Author(s):

Bo Yu ◽

Zhenbin Qian ◽

Xuemei Han ◽

Yunhai Tu ◽

Wencan Wu

Keyword(s):

Lacrimal Sac ◽

Endoscopic Endonasal ◽

Chronic Dacryocystitis

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In Vivo and Cadaver Studies of the Canalicular/Lacrimal Sac Mucosal Folds

Journal of Ophthalmology ◽

10.1155/2016/3453908 ◽

2016 ◽

Vol 2016 ◽

pp. 1-6 ◽

Cited By ~ 3

Author(s):

Yongsheng You ◽

Jing Cao ◽

Xiaogang Zhang ◽

Wencan Wu ◽

Tianlin Xiao ◽

...

Keyword(s):

Drainage System ◽

Lacrimal Sac ◽

Functional Roles ◽

Chronic Dacryocystitis ◽

Common Canaliculus ◽

Cadaver Studies ◽

Mucosal Folds ◽

Mucosal Fold ◽

Lacrimal Drainage

Purpose.The study aimed to investigate canalicular/lacrimal sac mucosal folds (CLS-MFs) in vivo and in cadavers in order to explore their functional roles in the lacrimal drainage system.Method.The observations of CLS-MFs in vivo were performed on 16 patients with chronic dacryocystitis after undergoing an endonasal endoscopic dacryocystorhinostomy (EE-DCR). The lacrimal sacs and common canaliculi of 19 adult cadavers were dissected. The opening/closing of an orifice and mucosal fold was recorded. All of the specimens were subjected to a histological examination.Results.The upper and lower lacrimal canaliculi in all of the samples united to form a common canaliculus that opened to the lacrimal sac. CLS-MFs were observed in 10 of the 16 patients (62.5%) and 9 of the 19 cadavers (47.4%). The orifices or mucosal folds could be opened or closed when related muscles contracted or relaxed. Histological sections showed a mucosal fold at one side of an orifice.Conclusion.Common canaliculus is the most common type that the canaliculus opens to lacrimal sac. CLS-MFs exist in a certain ratio that can be opened/closed with the movement of the orifices. They may be involved in the drainage of tears or the pathogenesis of acute dacryocystitis or lacrimal sac mucocele.

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Specific features of endoscopic dacryocystorhinostomy – case report

Romanian Journal of Rhinology ◽

10.1515/rjr-2015-0006 ◽

2015 ◽

Vol 5 (17) ◽

pp. 45-51

Author(s):

Lucian Lapusneanu ◽

Alina Neacsu ◽

Andreea Naca

Keyword(s):

Nasolacrimal Duct ◽

Stent Insertion ◽

Lacrimal Sac ◽

Endoscopic Dacryocystorhinostomy ◽

Evaluation Protocol ◽

Chronic Dacryocystitis ◽

History Of ◽

Ophthalmologic Examination ◽

Endoscopic Dcr ◽

Age Range

AbstractOBJECTIVE. The aim of the study was to evaluate the endoscopic dacryocystorhinostomy (DCR) with some particularities and its advantages over external DCR. MATERIAL AND METHODS. We evaluated 3 female patients (age range 35-84 years) diagnosed with chronic dacryocystitis - lacrimal sac abscess (2 cases) and lacrimal sac fistula (1 case). All patients presented a history of repeated episodes of acute dacryocystitis initially treated with broad spectrum antibiotics by the ophthalmologist. The evaluation protocol consisted in cranio-facial CT scan or MRI for the evaluation of the lacrimal sac and nasal structures, an ophthalmologic examination with the catheterization of the superior and inferior lacrimal punctum with a light probe to verify the permeability of the lacrimal pathway, and the Jones test with fluorescein to receive information about the common lacrimal path. Lacrimal syringing with regurgitation of fluid from the opposite punctum was the only criteria to decide the surgery. In all three cases we performed an endoscopic DCR, with stent insertion in two cases and a laco-dacryo-rhinostomy in one case. In only one case a reintervention was needed 12 months later. CONCLUSION. The endoscopic DCR, with its different particularities, is a safe surgical procedure with a low rate of complications, being the treatment of choice for the treatment of nasolacrimal duct obstruction.

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