scholarly journals Anatomy of the lacrimal apparatus from a rhinologist’s perspective: a review

2021 ◽  
Vol 7 (2) ◽  
pp. 403
Author(s):  
Manish Munjal ◽  
Shubham Munjal ◽  
Hitant Vohra ◽  
Anu Prabhakar ◽  
Ajay Kumar ◽  
...  
Keyword(s):  
Lacrimal Sac ◽  
Lacrimal Glands ◽  
Lacrimal System ◽  
Lacrimal Apparatus ◽  
Inferior Meatus ◽  
Plan Management

<p class="abstract">The postero-superioly situated lacrimal glands secreate tears to lubricate the exposed sclera, limbus and the cornea. The tears are ultimately are channeled into the antero-inferior sited lacrimal sac and thereby into the nasal inferior meatus. Epiphora may be secondary to irritative or obstructive pathology in the naso-lacrimal system.   Individual with epiphora necessitates intervention, medical or surgical.  The naso-lacrimal system with its unique anatomy has been elaborated upon to assist in detecting the precise site of pathology and plan management likewise.</p><p class="abstract"> </p>

scholarly journals Stent technique for endoscopic dacryocystorhinostomy – Our expertise

2016 ◽  
Vol 6 (21) ◽  
pp. 23-27
Author(s):  
Vlad Budu ◽  
Tatiana Decuseara ◽  
Bogdan Mocanu ◽  
Raluca Baican ◽  
Mihai Tusaliu ◽  
...  
Keyword(s):  
Success Rate ◽  
Lacrimal Sac ◽  
Lacrimal Duct ◽  
Bottom Edge ◽  
Duct Obstruction ◽  
Endoscopic Dacryocystorhinostomy ◽  
Lacrimal Apparatus ◽  
The Mean ◽  
Surgery Department ◽  
The Ideal

Abstract BACKGROUND. Endoscopic dacryocystorhinostomy is known to be the ideal treatment for saccal and postsaccal stenosis of the lacrimal apparatus. Following this surgery, an important inconvenient would be the stenosis of the created ostium with consecutive epiphora. MATERIAL AND METHODS. 20 patients with chronic unilateral lacrimal duct obstruction were operated in “Prof. Dr. D. Hociota” Institute of Phono-Audiology and Functional ENT Surgery, Department I, between January 2015 and July 2015. After creating the dacryocystorhinostoma, a stent was inserted transnasally to the bottom edge of the lacrimal sac and positioned to the bony margin of the ostium. Stents used varied in size from 1 to 3 mm in diameter. We followed-up our patients at 2 weeks and 1, 3, 6 months, assessing the symptoms of the lacrimal apparatus, especially the epiphora. RESULTS. The mean age of patients varied between 31 and 65. Most of our patients were women (n=14). In a total number of 16 patients epiphora disappeared, it decreased in 2 patients, and persisted in 2 patients. There were two patients with no changes who have spontaneously eliminated the stent 2 or 3 days after the surgery. The most widely used stent size was 3 mm diameter, with a success rate of 90%. CONCLUSION. The endoscopic approach may be an effective procedure in patients with pathologies of the lacrimal apparatus. In order to achieve an efficient result, both a preoperative rigorous preparation and also postoperative medical care are necessary. In conclusion, ostium stenting represents a better way to ensure a longer period of maintaining the permeability of the lacrimal apparatus.

OCT-meniscometry as a method for quantifying the balance of the lacrimal system

2021 ◽  
pp. 158-160
Author(s):  
I. Aldarraji ◽  
◽  
S. Shkolnik ◽  
G. Shkolnik ◽  
А. Vasilyeva ◽  
...  
Keyword(s):  
Sensitivity And Specificity ◽  
Accurate Method ◽  
Functional Tests ◽  
Dry Eyes ◽  
Non Invasive ◽  
Lacrimal System ◽  
Lacrimal Apparatus ◽  
Group 2 ◽  
Diagnostic Sensitivity And Specificity

All diseases of the lacrimal apparatus of the eye disrupt the balance of the lacrimal system either due to changes in the production of tears, or due to the insufficiency of its removal, so the study of the quantity and quality of tears on the eye surface allows us to reliably assess the effectiveness of methods of treating the pathology of the lacrimal organs. OCT-meniscometry is the only non-contact, non-invasive, accurate method of examining the lacrimal apparatus, which is reflected in the publications of many authors. The aim of our study was to improve the accuracy and automate the process of calculating the area of the lacrimal meniscus, as well as to evaluate the correlation between the indicators of OCT-meniscometry and functional tests. Materials and methods. The study included 50 patients with dacryostenosis (group 1), who were examined before and 1 month after surgical treatment (recanalization of SOP), as well as 30 patients without pathology of the lacrimal organs, who did not complain of lacrimation and dry eyes (group 2). All patients underwent a Schirmer and Norn test according to the generally accepted method, and OCT-meniscometry was performed using an optical coherence tomograph. The resulting OCT-meniscogram was transferred to a special mathematical program. Green's formula was used to calculate the area. Results. Meniscometry data had a strong correlation with functional tests (p<0.05) and high diagnostic sensitivity and specificity. Conclusion. The method of OCT-meniscometry has a higher sensitivity and specificity compared to routine tests, is less invasive, highly informative, which, of course, increases the reliability of the analysis of treatment results. Key words: meniscometry, TMA, lacrimal meniscus area, lacrimal system balance, dacryology.

scholarly journals Dacryocystitis Secondary to An Iatrogenic Foreign Body in the Lacrimal Apparatus

2009 ◽  
Vol 88 (7) ◽  
pp. 1001-1009 ◽  
Author(s):  
Deepak Gupta ◽  
Heikki B. Whittet ◽  
Salil Sood ◽  
Suchir Maitra
Keyword(s):  
Foreign Body ◽  
Nasolacrimal Duct ◽  
Lacrimal Sac ◽  
Lacrimal Apparatus

Dacryocystitis is an infection of the lacrimal sac that is usually caused by obstruction of the nasolacrimal duct. We describe a case of iatrogenic dacryocystitis that occurred secondary to the presence of an impacted piece of a metallic dilator in the lacrimal apparatus. The foreign body was detected on dacryocystography and removed during dacryocystorhinostomy. The patient recovered uneventfully.

Epiphora Secondary to Blockage of the Lacrimal System: The Role of Endonasal Dacryocystorhinostomy

1994 ◽  
Vol 8 (3) ◽  
pp. 139-142 ◽  
Author(s):  
Wolf J. Mann ◽  
Ronald G. Amedee ◽  
Franz Grehn ◽  
Wolfgang Lieb
Keyword(s):  
Sinus Surgery ◽  
Endonasal Approach ◽  
Lacrimal Sac ◽  
Endonasal Sinus Surgery ◽  
Lacrimal System

Stenosis of the lacrimal system may occur secondary to tumor, infection, trauma, and congenital etiologies. Attempts to remedy this problem often include irrigation and probing. However, if these fail, external or internal dacryocystorhinostomy (DCR) with or without stenting may be performed. The purpose of this article is to detail our experience with a microscopic endonasal approach to DCR utilized in 23 patients. This is a modification of an older accepted procedure which utilizes the modern techniques of endonasal sinus surgery. This approach has allowed for immediate restoration of drainage in 22 of 23 cases. In one case, the procedure was repeated because of restenosis at the level of the lacrimal sac, but ultimately successful drainage was obtained.

The Relationship of Lateral Osteotomies in Rhinoplasty to the Lacrimal Drainage System

1986 ◽  
Vol 94 (3) ◽  
pp. 362-367 ◽  
Author(s):  
J. Regan Thomas ◽  
Nancy Griner
Keyword(s):  
Drainage System ◽  
Osteotomy Site ◽  
Lacrimal Sac ◽  
Lacrimal Duct ◽  
Lacrimal Drainage System ◽  
Lacrimal System ◽  
Resident Surgeon ◽  
Relationship Of ◽  
The Relationship ◽  
Lacrimal Drainage

Damage to the lacrimal drainage system is a potentially complicating factor in rhinoplasty utilizing lateral osteotomies. The authors present data from osteotomies performed on a series of fresh cadavers. Following completion of the osteotomies, the lacrimal sac and nasal lacrimal ducts were Identified and cannulated. Soft tissue was dissected to demonstrate the osteotomy site. The specimen was inspected to delineate involvement (if any) of the lacrimal duct or sac. The proximity of the osteotomy site to the lacrimal drainage apparatus components was measured in each specimen. Various parameters were observed, including the effect of curved vs. straight osteotomes, guarded vs. unguarded osteotomes, and the effect of various widths of osteotomes. Likewise, the degree of risk to the lacrimal system was evaluated, and the technique of the novice and resident surgeon was compared to that of the experienced rhinoplastic surgeon. A low, curved osteotomy, performed with a sharp osteotome without subperiosteal tunnels, provides the safest maneuver. Lateral osteotomies, properly performed, prove to be an unusual cause of lacrimal drainage dysfunction.

scholarly journals Epithelial–Myoepithelial Carcinoma of the Lacrimal Sac and Literature Review of the Lacrimal System

2020 ◽  
Vol 11 ◽  
pp. 215265672092060
Author(s):  
Dhruv Sharma ◽  
Ashley Neiweem ◽  
Kyle Davis ◽  
Mark Prendes ◽  
Rao Chundury ◽  
...  
Keyword(s):  
Literature Review ◽  
Clinical Presentation ◽  
Definitive Treatment ◽  
Malignant Neoplasms ◽  
Low Grade ◽  
Open Approach ◽  
Myoepithelial Carcinoma ◽  
Lacrimal Sac ◽  
Lacrimal System ◽  
Epithelial Myoepithelial Carcinoma

Background Epithelial–myoepithelial carcinomas make up less than 0.1% of head and neck malignancies and are regarded as rare, low-grade malignant neoplasms of the salivary gland. They are thought to arise from intercalated ducts with histopathology showing a classic biphasic morphology of an outer layer of myoepithelial cells and inner layer of epithelial cells. These tumors most commonly occur in the parotid gland; however, rare cases have also been described in the nasal cavity, nasopharynx, subglottis, base of tongue, and the lacrimal gland. Objective To describe the clinical presentation, surgical management, and histopathology of the first reported case of lacrimal sac epithelial–myoepithelial carcinoma. To conduct a literature review of this malignancy, which is present in the lacrimal system. Methods Case report (n = 1) and literature review. Results We report a case of a 72-year-old man presenting with epiphora and a lacrimal sac mass with intranasal extension on imaging and nasal endoscopy. A combined endoscopic endonasal and open approach provided successful definitive treatment for final pathologic diagnosis of epithelial–myoepithelial carcinoma of the lacrimal sac, with orbital reconstruction and lacrimal stenting providing good cosmetic and functional results. Conclusions After PubMed database search for any case series or reports of lacrimal system epithelial–myoepithelial carcinomas, we believe this is the first documented case originating from the lacrimal sac. Although the histopathology of this tumor is distinct, unusual location and clinical presentation may pose significant diagnostic difficulties.

Dacryocystorhinostomy Utilizing an Anterior Lacrimal Sac Flap to Periosteum Technique

1979 ◽  
Vol 87 (2) ◽  
pp. 174-182 ◽  
Author(s):  
G. Richard Holt ◽  
Jean Edwards Holt ◽  
Edwin A. Cortez
Keyword(s):  
Effective Treatment ◽  
Nasal Mucosa ◽  
Drainage System ◽  
Lacrimal Sac ◽  
Pedicle Flap ◽  
Lacrimal System ◽  
Common Causes ◽  
Nasal Trauma ◽  
Anterior Lacrimal Crest ◽  
Lacrimal Drainage

Dacryocystorhinostomy is used in the effective treatment of epiphora secondary to obstruction of the lacrimal drainage system. Common causes of obstruction include canalicular disruption, lacrimal sac fibrosis, and external and internal nasal trauma. Most techniques of dacryocystorhinostomy attempt to suture the lacrimal sac mucosa to the nasal mucosa. At best this is technically difficult, and the mucosa frequently tears. A technique is presented using an anteriorly based lacrimal sac pedicle flap sutured to the periosteum of the anterior lacrimal crest. The sutured flap is quite strong, and the procedure is technically simpler than others. A brief description of the causes of lacrimal obstruction is given. The Jones primary and secondary dye tests for lacrimal system patency are reviewed.

scholarly journals MORPHOLOGY OF LACRIMAL GLANDS AND HARDERIAN GLAND IN LABORATORY RATS

2018 ◽  
Vol 18 (4) ◽  
pp. 132-137 ◽  
Author(s):  
A.L. Katsenko ◽  
O.A. Sherstyuk ◽  
R.L. Ustenko ◽  
N.L. Svintsytska ◽  
A.V. Piliuhin
Keyword(s):  
Spatial Organization ◽  
Harderian Gland ◽  
Histological Structure ◽  
Lacrimal Glands ◽  
Laboratory Rats ◽  
Lacrimal Apparatus ◽  
Age Related ◽  
Harderian Glands ◽  
Depth Study ◽  
Age Related Changes

Lacrimal apparatus of laboratory rodents and, in particular, rats has been comparatively well studied. The history of its research was presented in works by Levental and Kulchitskyi (1894, 1911.). The structure of human’s lacrimal glands has being studied and completed. Much attention was paid to the drainage of tears from the lacrimal sac to nasolacrimal canal in the humans and rats, age-related changes of secretory epithelium in lacrimal glands of rats, detailed study of the major lacrimal glands in humans (palpebral and orbital lobes). Otherwise, tear-producing and tear-secreting parts of human lacrimal apparatus are understudied organ microcomplexes. This research paper descrides the morphological and functional peculiarities of tear secretion ducts under normal functioning of lacrimal glands.Rats have two paired lacrimal glands. One of glands, smaller in size, is intraorbital (infraorbital) and another, larger, is exoorbital one. Exoorbital gland is larger than intraorbital one. Ducts of these glands join before opening through common duct into conjunctival sac in the external corner of the eye. Both lacrimal glands of rats originate from common embryonic germ and perform the same function and thus, are of the similar histological structure. Moreover, they demonstrate similar spectrum of age-related changes in the morphology. Orbits of rats whithin their boundaries form one more glandular formation, Harderian glands. They release the secretion, rich in lipids and porphyrines. Some scientists report that there no glands like those in humans, but others support the idea that they are in their germinal state. Changes in rats’ lacrimal glands and in Harderian glands can serve as models for simulating diseases of human lacrimal apparatus. This modeling requires in-depth study of spatial organization of the system of excretory ducts and their terminal excretory ducts in syntopic unity with hemomicrocirculatory bed of lacrimal glands in lab rats and humans. It is also important to carry out comparative morphological and stereomorphological analysis of data received, and to describe the peculiarities of the structure of lacrimal glands in lab rats and person.

scholarly journals Evaluation of the results endonasal dacrocystorhinostomy in patients with DCR

2017 ◽  
Vol 3 (2) ◽  
pp. 184
Author(s):  
Mukund Vaghela ◽  
Alpesh Patel ◽  
Vaibhav Patel ◽  
Ankur Dhanani
Keyword(s):  
Postoperative Complications ◽  
Lacrimal Sac ◽  
Endoscopic Endonasal ◽  
Lacrimal System ◽  
Lacrimal Drainage

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">Dacrocystitis refers to a series of clinical entities characterized by inflammation of lacrimal sac which leads to obstruction at the level of drainage of lacrimal system. Owing to the initial encouraging results and simplicity of the operation, it is decided that all symptomatic patients with lacrimal drainage obstruction would be treated initially by endoscopic endonasal dacrocystorhinostomy method, irrespective of the level of obstruction. </span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">A total 50 patients were included in the study over a period of 3-4 months. They were subjected to endonasal dacrocystorhinostomy and were evaluated for postoperative complications.  </span></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">Very few complications were seen postoperatively suggesting that this newer technique may be useful. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">Endonasal dacrocystorhinostomy may prove better in coming years.</span></p>

scholarly journals Congenital Lacrimal Sac Fistula: A Case Report and Literature Review

2020 ◽  
Vol 8 (4) ◽  
pp. 261-266
Author(s):  
Amir Ahmadzadeh Amiri ◽  
◽  
Asadollah Farrokhfar ◽  
Ahmad Ahmadzadeh Amiri ◽  
◽  
...  
Keyword(s):  
Surgical Repair ◽  
Renal Agenesis ◽  
Surgical Intervention ◽  
Surgical Techniques ◽  
Lacrimal Sac ◽  
Unilateral Lesion ◽  
Medial Canthus ◽  
Case Presentation ◽  
Lacrimal System ◽  
Medial Side

Introduction: Congenital lacrimal sac fistula is a rare anomaly of the lacrimal system in which, an epithelium-lined lacrimal tract is connected to the skin through a fistula. In most cases, it usually presents as an asymptomatic unilateral lesion located inferolateral to the medial canthus. Several studies reported that congenital lacrimal sac fistulas may be associated with systemic anomalies like Down syndrome, renal agenesis, etc. However, in this case, we aimed to report a patient with isolated bilateral congenital lacrimal sac fistula and its surgical management. Case presentation: A previously healthy 17 years old female presented with the complaint of intermittent watery discharge from her left eye since a few months ago. Physical examination revealed a small orifice in the skin at about 4 mm from the medial canthus on the medial side in both eyes without any signs of inflammation. Probing and irrigation in the left eye disclosed communication with the puncta and nose. Surgical repair was carried out through fistulectomy which successfully controlled the patient’s lacrimation. Conclusions: Recent advances in surgical techniques have shown better rates of success in relieving the patient’s lacrimation through fistulectomy than the simple excision methods. Our experience with the case presented here demonstrates that this lacrimal system anomaly can be treated successfully by surgical intervention. 

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