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PubMed2002

Lacrimal sac tumour presenting with blood-stained ocular discharge.

Malignant epithelial tumours of the lacrimal sac are uncommon. They can mimic chronic dacryocystitis or dacryostenosis to cause a delay in diagnosis. The presence of a medial canthal lump with blood-stained ocular discharge should arouse the suspicion of this diagnosis. The prognosis of lacrimal sac tumour is often guarded especially following tumour recurrence after incomplete resection. We report a patient with squamous cell carcinoma of the lacrimal sac to highlight its presentation and clinical course.

Adult↗
PubMed2002

[Ocular infections of the elderly].

A CLINICAL ASPECT DEPENDING ON THE PHYSIOPATHOGENESIS: Ocular infections are a frequent motive for ophthalmological consultations in geriatric settings because of the mechanical factors related to age (modifications in palpebral dynamics and lacrymal function) and in local and general immune factors leading to the rapid and/or more severe development of infections. The mechanism of microbial contamination of the eye also determines the clinical damage: predominantly local (dirty hands, traumas) with involvement of the surface tissues (conjunctive and cornea) or general, hematogenic or neurogenic, frequently at the origin of more internal infections (iris, choroid, retina, optical nerve). CONJUNCTIVITIS AND KERATITIS: These provoke reddening of the eyes, tears and above all pain when the corneal epithelium is involved. Microbiological samples are useful in cases of severe, presumably infectious keratitis or conjunctivitis. Two emergency situations must be distinguished: any suspicion of herpes for which local corticosteroids are contraindicated and keratitis or conjunctivitis with the use of lenses, often due to Gram negative bacilli, amoeba or fungus, the treatment of which is intensive and the prognosis often severe. OPHTHALMOLOGICAL HERPES ZOSTER: The rapid diagnosis and introduction of efficient doses of antivirals reduces the initial pain, the ocular complications of herpes zoster and post-zoster pain. The latter, when it exists, requires specialized management. ACUTE UVEITIS: A context of intra-ocular inflammation in an elderly patient must always evoke a pseudo-uveitis syndrome, the principle cause of which is lymphoma. Conversely, an uveitis occurring in the days or weeks following ocular surgery, including cataract, must be considered as suggestive of a post-surgical infection and rapidly referred to a specialist. ACUTE DACRYOCYSTITIS: Is manifested by a hard and painful tumefaction below the internal angle of the eye. Following collection, it requires draining through an in incision in the skin, washing and packing of the sac, and systemic antibiotherapy. The preventive treatment of recurrences requires open dacryocystorhinostomy or via endonasal endoscopy.

Acute Disease↗
PubMedDate not supplied

[Possibilities of using the method of crystallography of tears in pathologies of the lacrimal apparatus].

A total of 178 patients with pathologies in the lacrimal apparatus (including 81 patients with dacryocystitis, 51 patients with imperforation of the lacrimal canals' opening and 46 patients with dacryostenosis) were investigated. Crystallographic examination (CGE) of the lacrimal fluid was made for both eyes before and after surgery. 32 virtually healthy persons made up the control group. Normal types were defined and an operational scheme, which ensured the detection of 4 main types of crystals typical of the discussed pathologies, was elaborated. CGE was found to enable a reliable detection of relapses' threat, which can be a criterion in choosing the time for removing the intubation tube after canaliculardacryocystorhinostomy (CDCT) and an extra source of information in specifying a stage of dacryostenosis. CGE provides for determining indirectly the presence of an allergic or inflammatory component in the disease course. Finally, CGE is a simple and sufficiently informative method, which can turn into an additional tool in the diagnosis, differential diagnostics and evaluation of the efficiency of conducted therapy and in forecasting a clinical disease course in the lacrimal apparatus.

Adult↗
PubMed2002

[Study of computed tomographic dacryocystography used in endoscopic intranasal dacryocystorhinostomy preoperatively].

OBJECTIVE: To study computed tomographic dacryocystography used in endoscopic intranasal dacryocystorhinostomy preoperatively. METHOD: Ten volunteers and twelve patients with dacryocystitis were undergone the coronary and axial computed tomographic dacryocystography. RESULT: According to the anatomic relationship between anterior ethmoid sinus and fossa of lacrimal sac, the cells of anterior ethmoid sinus were classified into three typies: the result was that type I accounted for 12 sides (27.3%), type II 18 sides (40.9%), type III 14 sides (31.8%) by analysing the data of axial dacryocystographies; the sites of obstruction were connection of the lacrimal sac with nasolacrimal duct, the form of lacrimal sac of 11 patients was normal or enlarged lacrimal sacs, bilateral cricatrized lacrimal sacs were found in one patient by analysing the data of coronary dacryocystographies. CONCLUSION: Computed tomographic dacryocystography preoperatively can provide significant clinical guidance for the endoscopic transnasal dacryocystorhinostomy in locating the site of bone-opening.

Adult↗
PubMed2004

[Morphologic study of nasolacrimal duct mucosa-associated lymphoid tissue].

OBJECTIVE: To investigate the features of nasolacrimal duct MALT (mucosa-associated lymphoid tissue), and to explore the aetiology of chronic dacryocystitis. METHOD: The mucous of nasolacrimal duct, nasal cavity, pharyngeal and trachea of 20 rabbits were studied, and the lymphoid tissue and HEV of them were compared. RESULT: The number of lymphoid follicle and HEV in nasolacrimal duct epidermis were less than that in nasal cavity, pharyngeal and trachea (P<0.01). CONCLUSION: In normal condition the immune response of nasolacrimal duct membranae is lower than other mucosa of head-neck.

Animals↗
PubMed1992

[Conjunctivitis and lacrimal apparatus infections].

The term conjunctivitis covers all inflammatory processes affecting the conjunctiva. Bacterial and viral infections are the most frequent causes. Infectious conjunctivitis is rarely severe in industrialized countries, but trachomatous kerato-conjunctivitis is still the main cause of blindness all over the world. Most cases of bacterial conjunctivitis are treated with topical antibiotics. Viral conjunctivitis is frequent and, with the exception of herpetic conjunctivitis, has no specific treatment. Canaliculitis and dacryocystitis are rare but require specialized examination, treatment and follow-up.

Conjunctivitis↗
PubMedDate not supplied

[Intranasal dacryocystorhinostomy in children].

Endonasal dacryocystorhinostomy performed in 78 children gave a steady favourable effect. Such a surgical operation is also recommended in dacryocysts complicated by phlegmons. Concomitant external fistulae of the lacrimal sac usually spontaneously closed after the operation, large fistulas were sutured.

Adolescent↗
PubMed2006

[Antibiotic resistance in Streptococcus pneumoniae strains isolated from sterile body sites].

Antibiotic resistance in Streptococcus pneumoniae has become an important issue in the last years. Penicillin resistance rates vary among countries and among different regions in countries. It is important to know penicillin resistance rates among isolates, in planning empirical antimicrobial therapy in pneumococcal infections. In this study, the antibiotic resistance rates of S. pneumoniae strains isolated from sterile body sites were investigated with both E-test and disc diffusion methods for penicillin, erythromycin, levofloxacin, and with only disc diffusion method for chloramphenicol, ceftriaxone, vancomycin, rifampin, trimethoprim-sulfamethoxazole (TMP-SMX), clindamycin, and tetracycline. A total of 165 strains were included into the study of which 52 were isolated from blood, 46 from cerebrospinal fluids, 25 from pleural fluids, 24 from dacryocystitis materials, 13 from tympanocentesis materials, 3 from joint fluids and 2 from wound specimens. Intermediate resistance to penicilin was 18.8%, while the resistance rates to TMP-SMX, tetracycline, chloramphenicol, erythromycin and levofloxacin were detected as 21.2%, 10.9%, 9.7%, 5.4% and 0.6%, respectively. None of the isolates were highly resistant to penicillin, nor resistant to vancomycin, ceftriaxone and rifampin. In conclusion, penicillin is still the first line therapeutic agent for pneumococcal infections except for severe infections such as meningitis, in our region.

Anti-Bacterial Agents↗
PubMed2006

[Endonasal anatomy of lacrimal sac and its clinical significance in dacryocystorhinostomy].

OBJECTIVE: To explore the intranasal surface localization of the lacrimal sac in endoscopic dacryocystorhinostomy. METHODS: Fifteen adult cadavers (30 sides) were studied, the data of projection position of the lacrimal sac on the lateral wall of nasal cavity were measured. RESULTS: In 2/3 cadavers, the lacrimal sac is located above the axilla of the middle turbinate, and 1/3 lies below it. A majority of the lacrimal sac (2/3) are located below the entry point of the common lacrimal canaliculus, about 1/3 lies above it. Inner canthal ligament projects on the middle of the lacrimal sac, almost equal to the level of common lacrimal canaliculus. Thirty-two cases (thirty-nine sides) of chronic dacryocystitis were followed-up > 6 months after operation. Thirty-five sides were cured, 2 sides improved and 2 sides ineffective. The cure rate was 89.8%, improve rate 5.1% and ineffective rate 5.1%, respectively, and the total effective rate was 94.9%. CONCLUSIONS: The central position of dacryocystorhinostomy should be 0.2 cm above the front of the axilla of the middle turbinate, to make an curved mucous membrane incision 0.8 cm above and 0. 4 cm below the front of the axilla of the middle turbinate and bone ostium about 1.2 cm x 1.0 cm. It is the best position in endoscopic dacryocystorhinostomy. Locating the inner canthal ligament with a bayonet type forceps to find the projection of lacrimal sac is also a simple and easy method.

Adult↗
PubMedDate not supplied

[Pathological changes found in the lacrimal sac during nasolacrimal duct surgery].

In the course of 489 external dacryocystorhinostomies one found: 19 pseudotumors (granulomas and inflammatory granulations), 6 true tumors (1 papilloma, 1 congenital cyst, 1 lymphoma), 6 cases of calcium deposits and stones and 1 case of epithelial metaplasia. The author points to a great number of pseudotumors which are the effect of a long-standing process of dacryocystitis treated conservatively without effect. She thinks that the surgical treatment should be undertaken as fast as possible.

Dacryocystitis↗
PubMedDate not supplied

[Lacrimal sac hydrops: etiology, pathogenesis, clinical aspects, treatment].

Thirty-three patients (35 observations) with lacrimal sac hydrops, aged 16 to 84, 31 females and 2 male ones, were examined and operated on. The condition was bilateral in 2 patients. The studies have revealed that lacrimal sac hydrops may develop in chronic dacryocystitis in various periods of this conditions, starting from 2-3 months up to 5-7 years. In 25 cases the condition developed because of lacrimal canaliculi orifice blocking, in 10 because of canalicular orifice obliteration. In 30 patients yellowish-white viscous stinking purulent discharge was found in the lacrimal sac closed cavity, in 5 mucous-serous fluid. Present-day surgical methods have proved to be highly effective in the management of hydrops. In 10 patients with canalicular orifice obliteration canaliculodacryocystorhinostomy was carried out with temporary silicone tube intubation of the canaliculus; remote results were completely successful in 8 patients and partially effective in 2. In the rest 25 cases dacryocystorhinostomy was carried out with completely effective remote results in all the patients.

Adolescent↗
PubMed1990

Lacrimal conjunctivitis.

In the course of an acute phase of pneumococcal conjunctivitis, a serpiginous corneal ulcer has never been reported to develop. However, if there is a pneumococcal chronic dacryocystitis and a resultant lacrimal conjunctivitis, the association with pneumococcal serpiginous ulcers is significant. This is most likely due to the fact that those serological types that are particularly virulent for the cornea have an affinity to colonize and infect the lacrimal sac.

Conjunctivitis↗
PubMedDate not supplied

[Carcinoma of the lacrimal sac].

The present paper reports on the case of a 63 year-old woman twice operated for chronic suppurated dacryocystitis. At the third operation the lacrimal sac which was enlarged and rigid was removed. Section of the sac revealed a pinkish-grey formation that occupied the entire lumen of the sac. Histologic examination showed a poorly differentiated carcinoma with an islet-alveolar distribution. Stress is laid on the rare occurrence of primary malignant tumours of the lacrimal sac and the diagnostic difficulties in the onset period.

Carcinoma↗
PubMed1987

Plasma cell granuloma of the lacrimal sac.

A 31-year-old man with a 2-year history of recurrent dacryocystitis underwent dacryocystorhinostomy. An unexpected operative finding was a polyp in the lacrimal sac. Histopathological examination revealed a plasma cell granuloma. The nature of this uncommon inflammatory pseudotumour of the lacrimal sac is discussed.

Adult↗
PubMed1986

[Bacterial etiology of eye infections].

The purpose of this study was to determine the etiologic agents in bacterial ocular infections, their antibiotic sensitivities and the most suitable conditions for the microbiological diagnosis, using several methods. 200 patients who were diagnosed to have bacterial conjuntivitis (111 cases), corneal ulcers (39 cases), dacryocystitis (34 cases) or infections of the eyelids (16 cases) at the ophthalmology department of our university were taken as the patient group and there were 100 normal people in the control group. The frequency and species of bacteria isolated from both groups are similar to those in the literature. In cases of conjunctivitis, the results of the direct smears were parallel to the results obtained by cultures in 8.2% of the cases. The percentage of growth was higher when the specimen was inoculated immediately in the clinic compared to the results obtained by inoculations which were performed in the laboratory. According to the results of the antibiotic sensitivity tests, chloramphenicol should take the first place among the antibiotics which are in general use for gr (+) and gr (-) bacteria, and tetracyclines should take the second place while waiting for the results of the cultures.

Bacteria↗
PubMed1979

Nasolacrimal duct obstruction following transantral-ethmoidal orbital decompression.

Of 200 patients undergoing bilateral transantral-ethmoidal orbital decompression for Graves' ophthalmopathy, nine suffered symptomatic postoperative obstruction of the lower nasolacrimal excretory system. Five of the nine patients had persistent symptoms of epiphora or repeated episodes of dacryocystitis that necessitated dacryocystorhinostomy. Dacryocystorhinostomy relieved symptoms and objective evidence of obstruction in these five patients. We believe that nasolacrimal duct obstruction occurred in these patients as a complication of nasoantral window construction.

Dacryocystitis↗
PubMed1977

Nasolacrimal duct reconstruction with the nasolacrimal duct prosthesis: an alternative to standard dacryocystorhinostomy.

For many years the standard surgical treatment for chronic dacryocystitis has been the edge-to-edge anastomosis of the lacrimal sac mucosa to nasal mucosa over the margins of a hole made through the lacrimal bone. Failures of this standard procedure have been attributed to many factors and complications frequently require reoperation. The procedure described in this paper was developed as a means of overcoming some of these difficulties. It provides a normal, gravity draining, nasolacrimal duct system without pooling and not requiring destruction of the lacrimal bone or alteration of normal anatomy. It consists of the implantation of a permanent indwelling nasolacrimal duct prosthesis (available from Concept, Inc., Clearwater, FL) from the base of the sac through the interosseous canal into the vault of the inferior nasal meatus. Because it does not involve bypassing the normal lacrimal drainage system, the technique is more simple and less traumatic. This method of reconstruction of the nasolacrimal duct has converted a major hour and a half procedure into a 15 minute operation. Because normal anatomic relationships are retained, the nasolacrimal duct prostheis gives reasonable assurance of permanent drainage and is recommended as a primary procedure of choice.

Dacryocystitis↗