Candida parapsilosis associated with dacryoliths in obstructive dacryocystitis.
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Dacryocystorhinostomy (DCR) was done in five patients in Mulago Hospital between 1986 and 1991. A reasonable cure rate was realised. Based on the favourable results of these cases, it is recommended that dacryocystorhinostomy should be considered earlier if repeated syringing and probing fail to clear epiphora due to irreversible nasal lacrimal duct obstruction.
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A 4-year-old castrated male Golden Retriever was referred for evaluation of intermittent purulent discharge from the right eye of 4-months' duration. A radiolucent area in the maxillary bone was detected on examination of skull radiographs. Dacryocystorhinography revealed pooling of contrast material in the radiolucent area. A rhinotomy was performed, and a large opening between the cystic structure of the nasolacrimal system and the nasal cavity was created. Epiphora resolved after surgery and had not recurred by 9 months after surgery. Two other dogs had cystic structures of the nasolacrimal system and were treated surgically to allow drainage into the nasal cavity.
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Based on dissection and measurement on 20 adult head cadavers, there is the close relationship between lacrimal duct and lateral wall of the nasal cavity. The cells of anterior ethmoid sinus were classified into three degrees, according to the relationship between the anterior ethmoid sinus and the lacrimal sac fossa. The average distance is 6.74 +/- 1.72 mm between the nasolacrimal duct and the upper part of the uncinate process, 3.44 +/- 0.75 mm and 5.50 +/- 3.73 mm from the nasolacrimal duct to ethmoidal infundibulum and the maxillary ostium. The orifice of the duct most commonly opens under the insertion of the inferior turbinate anteriorly. To perform intranasal sinus surgery, the safest area and key operation approach were discussed.
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