scholarly journals Nasolacrimal Duct Obstruction: An Unusual Presentation of Sarcoidosis

2020 ◽  
pp. 014556132095049
Author(s):  
Samih J. Nassif ◽  
Devin Ruiz ◽  
Alison Callahan ◽  
Elie E. Rebeiz
Keyword(s):  
Ct Scan ◽  
Drainage System ◽  
Nasolacrimal Duct ◽  
Nasolacrimal Duct Obstruction ◽  
Duct Obstruction ◽  
Nasal Tissue ◽  
History Of ◽  
Lacrimal Bone ◽  
Subepithelial Layer ◽  
Noncaseating Granulomas

Lacrimal drainage system disorders leading to epiphora are a common ophthalmologic complaint. When such a patient is identified, the ophthalmologist frequently collaborates with the otolaryngologist to perform a dacryocystorhinostomy (DCR). In rare cases, sinonasal sarcoidosis may lead to nasolacrimal duct obstruction (NLD) and dacryocystitis. A 48-year-old Caucasian female was referred to the Otolaryngology clinic for evaluation of a 6-month history of persistent right-sided nasal obstruction and epiphora. After physical examination and computerized tomography (CT) scan, she was diagnosed with right NLD with dacryocystitis. The patient underwent right endoscopic DCR. Pathology from the lacrimal bone and nasal tissue demonstrated noncaseating granulomas suggestive of sarcoidosis. Postoperative evaluation including lung CT scan confirmed systemic sarcoidosis. Nasolacrimal duct obstruction very rarely is the presenting symptom in patients with sarcoidosis. Imaging is necessary to rule out other causes of NLD, and histopathology is essential for diagnosis. Noncaseating granulomas are found along the nasal tissue and lacrimal sac, specifically in the subepithelial layer. Treatment consists of DCR, either endoscopic or external. Both approaches achieve long-lasting resolution of symptoms but may require revision from inflammation and scarring. There is no consensus on the use of intraoperative or postoperative steroids.

scholarly journals Endoscopic dacryocystorhinostomy for nasolacrimal duct obstruction: an assessment of post-operative outcomes at a tertiary health care centre

2021 ◽  
Author(s):  
R. K. L. N. Raju Dantuluri
Keyword(s):  
Health Care ◽  
Success Rate ◽  
Drainage System ◽  
Nasolacrimal Duct ◽  
Nasolacrimal Duct Obstruction ◽  
Deviated Nasal Septum ◽  
Health Care Centre ◽  
Duct Obstruction ◽  
Endoscopic Dacryocystorhinostomy ◽  
Operative Outcomes

Background: Endoscopic dacryocystorhinostomy (Endo DCR) is a well-established surgical treatment for nasolacrimal duct obstruction (NLDO) cases. Advances in surgical technique and a better understanding of the anatomy have resulted in improvement of the success rate. The objective of this study is to assess the factors responsible for the recurrence of nasolacrimal system obstruction by evaluating the post-operative outcomes of Endo DCR at a tertiary health care centre.Methods: A retrospective study was conducted in the department of ENT, GVP IHC and MT, Visakhapatnam – Andhra Pradesh on 52 patients who underwent Endo DCR procedure from September 2018 to September 2021. The data regarding lacrimal drainage system, operative details, surgical outcomes and complications were analysed.Results: Fifty-two patients (18 male and 34 female) underwent 63 Endo DCR surgeries for NLDO. Success was achieved in 50 cases (79.4%), and failure in 13 (20.6%). Of the 13 failed cases, anatomical obstruction at the fistula site was found in 6 (46.2% of failed cases), whereas functional failure with no evidence of obstruction was found in 7 (53.8%).Conclusions: The success rate appears to be influenced by preoperative parameters like clinical as well as radiological examination of eye and nose; ruling out intraoperative conditions like sinusitis, deviated nasal septum, polyps. These are essential for better coordinating therapeutic expectations and better patient selection. Endo DCR proved to be a safe invasive procedure as it has direct approach to the sac and produced excellent results without any external scar.

scholarly journals Nasolacrimal Duct Obstruction Caused by Lymphoproliferative Infiltration in the Course of Chronic Lymphocytic Leukemia

2015 ◽  
Vol 6 (3) ◽  
pp. ar.2015.6.0130 ◽  
Author(s):  
Ralph Litschel ◽  
Marco Siano ◽  
Abel-Jan Tasman ◽  
Sergio Cogliatti
Keyword(s):  
Standard Treatment ◽  
Malignant Tumors ◽  
Drainage System ◽  
Nasolacrimal Duct ◽  
Lymphocytic Leukemia ◽  
Nasolacrimal Duct Obstruction ◽  
Duct Obstruction ◽  
Proactive Approach ◽  
Lymphatic Leukemia ◽  
Lacrimal Drainage

Background Endoscopic dacryocystorhinostomy (DCR) is the standard treatment of nasolacrimal duct obstruction. Only in rare cases, blockage may be caused by malignant tumors and even more exceptionally by lymphatic neoplasms so that biopsies are not routinely taken for diagnostic purposes. Methods A computerized retrieval system was used for this retrospective study to identify all patients with histologically documented lymphoproliferative infiltration in the lacrimal drainage system from 2001 to 2009. Results In four of 191 patients (2.1%), infiltration of the nasolacrimal sac mucosa with a small lymphocytic lymphoma (SLL)/chronic lymphatic leukemia (CLL) was found. Patients who develop symptoms like epiphora within the course of known CLL are highly suspicious for lymphoproliferative infiltration of the lacrimal drainage associated lymphoid tissue. Conclusion A proactive approach with ophthalmologic consultation and DCR should be followed in these patients to avoid dacryocystitis.

Usefulness of high definition sialoendoscope for evaluation of lacrimal drainage system in congenital nasolacrimal duct obstruction

2021 ◽  
pp. 112067212110080
Author(s):  
Nishi Gupta ◽  
Poonam Singla ◽  
Suma Ganesh
Keyword(s):  
Light Transmission ◽  
Drainage System ◽  
Nasolacrimal Duct ◽  
Nasolacrimal Duct Obstruction ◽  
High Definition ◽  
Congenital Nasolacrimal Duct Obstruction ◽  
Duct Obstruction ◽  
Lacrimal Drainage System ◽  
Membranous Obstruction ◽  
Lacrimal Drainage

Purpose: Sialoendoscope was used as a dacryoendoscope, high- definition images of the lacrimal drainage system (LDS) were captured and its performance in congenital nasolacrimal duct obstruction (CNLDO) is reported. Methods: Nasal endoscopy was done as the first in all the cases using a 0°, 2.7 mm nasal endoscope (Karl Stroz Tutlingan Germany). This was followed by Dacryoendoscopy (DEN) of the lacrimal drainage system from puncta till the valve of Hasner. DEN was performed under general anaesthesia in 26 children (including 17 primary and 9 failed probing cases). All cases were examined using 0.8 mm sialoendoscope (Karl Storz, Tuttlingen, Germany) with fibreoptic light transmission with a side port for irrigation. Results: We were able to obtain high-definition images of canaliculi, lacrimal sac, sac duct junction, proximal, mid and distal segments of nasolacrimal duct in all the children with CNLDO. In 17 primary cases 16 had distal membranous obstruction and I case had proximal canalicular obstruction. In nine children with history of failed probing, five had membranous obstruction, two had dacryoliths, two had NLD malformation at different levels. An overall success rate of 88.4% was achieved. Conclusion: Sialoendoscope can be used as high-definition dacryoendoscope for diagnostic and therapeutic use in CNLDO. Useful information can be obtained on dacryoendoscopy in complex CNLDO cases.

Incidence of neoplasia in patients with unilateral epiphora

2015 ◽  
Vol 129 (S3) ◽  
pp. S53-S57 ◽  
Author(s):  
T Bewes ◽  
R Sacks ◽  
P L Sacks ◽  
D Chin ◽  
N Mrad ◽  
...  
Keyword(s):  
Nasolacrimal Duct ◽  
Nasolacrimal Duct Obstruction ◽  
Stricture Formation ◽  
Benign Stricture ◽  
Common Cause ◽  
Duct Obstruction ◽  
Lacrimal System ◽  
History Of ◽  
Surgical Teams ◽  
Operative Findings

AbstractBackground:Nasolacrimal duct obstruction is common and is usually a result of benign stricture formation. Although neoplasia near or around the lacrimal system may produce epiphora, the incidence of neoplasia from within the lacrimal system as a cause of nasolacrimal duct obstruction is not well documented.Methods:A retrospective study was performed on all patients undergoing dacryocystorhinostomy with a history of epiphora. The incidence of patients with operative findings of intra-lacrimal neoplasm was sought. Histopathologically confirmed cases were included.Results:The study comprised 537 patients, who underwent a total of 631 endoscopic dacryocystorhinostomy procedures between January 1998 and July 2013. Non-stenotic causes of nasolacrimal duct obstruction were encountered in 3.01 per cent of dacryocystorhinostomy procedures, and included neoplastic, inflammatory and infectious pathologies. Inverted papilloma was the most common cause, encountered in 0.79 per cent of dacryocystorhinostomy operations.Conclusion:These findings suggest that neoplasia is an uncommon but not a rare cause of nasolacrimal duct obstruction. Surgical teams performing high numbers of dacryocystorhinostomy procedures should be aware of such pathology and patients counselled appropriately.

scholarly journals Prevalence of Congenital Nasolacrimal Duct Obstruction and its related risk factors among newborns

2021 ◽  
pp. 158-165
Keyword(s):  
Risk Factors ◽  
Drainage System ◽  
Cross Sectional Study ◽  
Nasolacrimal Duct ◽  
Nasolacrimal Duct Obstruction ◽  
Common Symptom ◽  
Related Factors ◽  
Cross Sectional ◽  
Congenital Nasolacrimal Duct Obstruction ◽  
Duct Obstruction

Introduction: Lacrimal drainage system disorders are among the most common ocular disorders faced by physicians. The prevalence of congenital nasolacrimal duct obstruction (CNLDO) is different in various studies, and the role of such factors as maternal and neonatal demographic characteristics have not been completely investigated in CNLDO. The present study aimed to assess the prevalence of CNLDO and its related factors in newborns in Sabzevar. Methods: This cross-sectional study was conducted on 541 newborns in Shahidan Mobini hospital, Sabzevar, Iran from January to February 2015 after obtaining informed consent from their parents. Data were collected by interviewing mothers, filling out checklists, and physical examination of the newborns. Data analysis was carried out in Stata software using a logistic regression test at a 95% confidence interval. Results: The prevalence of CNLDO was 22.6%. Purulent ocular discharge was the most common symptom (16.82%). There was a significant relationship between the neonate’s head circumference and the incidence of CNLDO (P= 0.01); nonetheless, CNLDO in the newborns showed no significant association with weight, height, and Apgar score (P>0.05). Conclusion: Considering the significant prevalence of CNLDO in preterm and term neonates, as well as its variable prevalence rates reported in different studies and the absence of overlapping of various risk factors of such disorder, it is recommended to carry out more thorough studies from birth to 1 year of age.

scholarly journals Conservative Treatment for Congenital Nasolacrimal Duct Obstruction – Factors Affecting the Success

2021 ◽  
Vol 48 (2) ◽  
pp. 25-28
Author(s):  
K. P. Valcheva ◽  
S. V. Murgova
Keyword(s):  
Conservative Treatment ◽  
Clinical Signs ◽  
Nasolacrimal Duct ◽  
Nasolacrimal Duct Obstruction ◽  
Congenital Nasolacrimal Duct Obstruction ◽  
Factors Affecting ◽  
Duct Obstruction ◽  
Nonsurgical Management ◽  
History Of ◽  
A Prospective Study

Abstract Aim To examine the success rate and factors affecting the effect of conservative treatment for congenital nasolacrimal duct obstruction (CNLDO) in children. Methodology A prospective study was made on 167 eyes of 131 patients with clinical signs of CNLDO. All of them were initially treated nonsurgically with Crigler massage. The curative effect of this management was evaluated on the basis of no history of watery eyes, negative regurgitation test, and dye disappearance test 0 or 1 grade. Exploratory analyses assessed whether baseline characteristics including age, gender and laterality were associated with the probability of CNLDO resolving without surgery. If the nonsurgical treatment failed, probing was done in the Eye Clinic in Pleven. Results The conservative treatment for CNLDO with Crigler massage was successful in the majority of treated cases – in 115 out of 167 eyes with CNLDO (68,9%). The remaining 52 (31,1%) eyes were probed. Age (p = 0,001) and laterality (p = 0,001) were found to be associated with resolution of the clinical signs. Conclusions Nonsurgical management for CNLDO was successful initial treatment in patients with this pathology. The Crigler massage was more effective in children up to 12 months of age with unilateral obstruction.

scholarly journals OUTCOME OF INITIAL 100 CASES OF ENDOSCOPIC DACRYOCYSTORHINOSTOMY IN KIRKUK

2020 ◽  
Vol 3 (2) ◽  
pp. 208-217
Author(s):  
Tunjai faiq
Keyword(s):  
Complete Removal ◽  
Nasolacrimal Duct ◽  
Nasolacrimal Duct Obstruction ◽  
Anterior Maxilla ◽  
Duct Obstruction ◽  
Endoscopic Dacryocystorhinostomy ◽  
Operation Period ◽  
Adults And Children ◽  
Lacrimal Bone ◽  
Silicone Intubation

This study aimed at determining the effect and safety of endoscopic dacryocystorhinostomy (ENDO-DCR) in initial 100 cases of nasolacrimal duct obstruction. This study was done in Kirkuk general hospital from 2010 to 2017 with a total of 100 cases. A standardized method was applied to all cases through employing an endonasal technique to the lachrymal sac. Then, an operative resection was applied to the mucosa of nose, lacrimal bone and a part of the anterior maxilla. Next, a complete removal of the medial wall of the lacrimal sac was done. A tube of canalicular silicone intubation was placed for 6 months after operation. The key results of such measures were epiphora resolution, lack of discharge and clearness of the ostium. The success of ENDO-DCR method with adjunctive tube of canalicular silicon intubation was demonstrated in 80 cases (80%) and 10 cases represented acceptable improvements. However, there were minor complications faced during or after operation period. Finaly Endoscopic dacryocystorhinostomy is a safe and effective method for treating nasolacrimal duct obstruction in adults and children with nasolacrimal duct obstruction and epiphora.

Is there an association between congenital nasolacrimal duct obstruction and cesarean delivery?

2019 ◽  
Vol 30 (6) ◽  
pp. 1228-1231
Author(s):  
Mehmet Fuat Alakus ◽  
Umut Dag ◽  
Selahattin Balsak ◽  
Seyfettin Erdem ◽  
Hasan Oncul ◽  
...  
Keyword(s):  
Family History ◽  
Cesarean Section ◽  
Positive Family History ◽  
Nasolacrimal Duct ◽  
Nasolacrimal Duct Obstruction ◽  
First Birth ◽  
Congenital Nasolacrimal Duct Obstruction ◽  
Duct Obstruction ◽  
Obstruction Group ◽  
History Of

Purpose: The aim of this study was to research the relationship between types of birth and congenital nasolacrimal duct obstruction. Method: The study enrolled 665 infantile patients with prediagnosis of congenital nasolacrimal duct obstruction due to associated ophthalmic symptoms. Age, gender, family history, delivery type, and patient medical records were investigated. Patients were grouped and compared according to their birth type and whether it was the first birth. Results: The number of the infants with and without congenital nasolacrimal duct obstruction was 227 (34.1%) and 438 (65.9%), respectively. Comparison of the congenital nasolacrimal duct obstruction and non-congenital nasolacrimal duct obstruction groups according to the first births showed that ratio of cesarean section was significantly higher in the congenital nasolacrimal duct obstruction group than the non- congenital nasolacrimal duct obstruction group (58.7% and 20.7%, respectively). Number with positive family history also was significantly higher in the congenital nasolacrimal duct obstruction group. Conclusion: Cesarean section in first birth and positive family history of congenital nasolacrimal duct obstruction appear to be important risk factors in the etiopathogenesis of congenital nasolacrimal duct obstruction.

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