Hostname: page-component-cd9895bd7-fscjk Total loading time: 0 Render date: 2024-12-23T07:45:04.919Z Has data issue: false hasContentIssue false
  • English
  • Français

Bony nasolacrimal duct dehiscence in functional endoscopic sinus surgery: radiological study and discussion of surgical implications

Published online by Cambridge University Press:  08 April 2015

M J Ali ,
J Murphy ,
P J Wormald  and
A J Psaltis
M J Ali
Affiliation:
Dacryology Service, L V Prasad Eye Institute, Hyderabad, India
J Murphy
Affiliation:
Department of Otolaryngology – Head Neck Surgery, University of Adelaide, South Australia, Australia
P J Wormald
Affiliation:
Department of Otolaryngology – Head Neck Surgery, University of Adelaide, South Australia, Australia
A J Psaltis*
Affiliation:
Department of Otolaryngology – Head Neck Surgery, University of Adelaide, South Australia, Australia
*
Address for correspondence: Dr Alkis James Psaltis, Department of Otolaryngology – Head Neck Surgery, University of Adelaide, Adelaide, South Australia, Australia E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives:

To analyse the radiological features of the bony nasolacrimal duct before and after functional endoscopic sinus surgery, and document the incidence of surgically induced dehiscence.

Methods:

A retrospective case series analysis was conducted of 63 consecutive patients who underwent uncinectomy as a part of 118 functional endoscopic sinus surgical procedures. All patients underwent pre- and post-operative computed tomography scans. Axial computed tomography images at the level of maxillary sinus were evaluated for the presence of bony nasolacrimal duct dehiscence, osteitis and completeness of uncinectomy.

Results:

The rate of nasolacrimal duct dehiscence prior to surgery was 6.8 per cent (8 out of 118 cases). Nasolacrimal duct dehiscence as a consequence of surgery was observed in 3.3 per cent of cases (4 out of 118), with a further 4.2 per cent (5 out of 118) showing post-operative reactive bony change of the nasolacrimal duct in the absence of dehiscence.

Conclusion:

The incidence of nasolacrimal duct injury observed was much lower than that previously reported in the literature.

Keywords

Nasolacrimal DuctSinus SurgeryFESSComplicationsDehiscence, Surgical WoundCT Scan, X-RayLund-Mackay Scores
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 129 , Supplement S3 , July 2015 , pp. S35 - S40
Copyright
Copyright © JLO (1984) Limited 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Whitnall, SE. Anatomy of the Human Orbit and Accessory Organs of Vision, 2nd edn.New York: Krieger Publishing, 1979;164–5Google Scholar
2Burkat, CN, Lucarelli, MJ. Anatomy of the lacrimal system. In: Cohen, AJ, Brazzo, B, eds. The Lacrimal System: Diagnosis, Management, and Surgery. New York: Springer, 2006;3–19CrossRefGoogle Scholar
3Shoshani, Y, Samet, N, Ardekian, L, Taicher, S. Nasolacrimal duct injury after Le-Fort I osteotomy. J Oral Maxillofac Surg 1994;52:406–7CrossRefGoogle ScholarPubMed
4Osguthorpe, JD, Hoang, G. Nasolacrimal injuries: evaluation and management. Otolaryngol Clin North Am 1991;24:59–78CrossRefGoogle ScholarPubMed
5Demas, PN, Sotereanos, GC. Incidence of nasolacrimal injury and turbinectomy–associated atrophic rhinitis with Le-Fort I osteotomies. J Craniomaxillofac Surg 1989;17:116–8CrossRefGoogle ScholarPubMed
6Lauritzen, C, Lilja, J. Nasolacrimal obstruction in craniofacial surgery. Scand J Plast Reconstr Surg 1985;19:269–72Google ScholarPubMed
7Serdahl, CL, Berries, CE, Chole, RA. Nasolacrimal duct obstruction after endoscopic sinus surgery. Arch Ophthalmol 1990;108:391–2CrossRefGoogle ScholarPubMed
8Kennedy, DW, Zinreich, SJ, Shaalan, H, Kuhn, F, Naclerio, R, Loch, E. Endosocopic middle meatal antrostomy: theory, technique, patency. Laryngoscope 1987;97:1–9CrossRefGoogle Scholar
9Bolger, WE, Parsons, DS, Mair, EA, Kuhn, FA. Lacrimal drainage system injury in functional endoscopic sinus surgery. Arch Otolaryngol Head Neck Surg 1992;118:1179–84CrossRefGoogle ScholarPubMed
10Unlu, HH, Goktan, C, Aslan, A, Tarhan, S. Injury to the lacrimal apparatus after endoscopic sinus surgery: surgical implications from active transport dacryocystography. Otolaryngol Head Neck Surg 2001;124:308–12CrossRefGoogle Scholar
11Nakayama, T, Asaka, D, Okushi, T, Yoshikawa, M, Moriyama, H, Otori, N. Endoscopic medial maxillectomy with preservation of inferior turbinate and nasolacrimal duct. Am J Rhinol Allergy 2012;26:405–8CrossRefGoogle ScholarPubMed
12Sadeghi, N, Joshi, A. Management of the nasolacrimal system during transnasal endoscopic medial maxillectomy. Am J Rhinol Allergy 2012;26:e85–8CrossRefGoogle ScholarPubMed