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Results for “NASOLACRIMAL DUCT”

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PubMed1997

[Stent implantation and balloon dilatation in the treatment of stenosis and obstruction of the lacrimal apparatus].

PURPOSE: To evaluate treatment of epiphora caused by obstructions of the nasolacrimal duct system with balloon dilatation and stent implantation. MATERIAL AND METHODS: 28 dacryocystoplasties were performed in 20 patients with complete (n = 7) or incomplete (n = 13) obstruction of the nasolacrimal duct system. RESULTS: Dacryocystoplasty was technically successful performed in 26 cases (93%). Recanalisation was not achieved in two patients with complete obstructions. 17 patients showed complete or partial resolution of epiphora during follow-up of up to two years (clinical success 85%). Complete reobstruction occurred only in one patient 9 months after balloon dilatation and recanalisation was not possible. CONCLUSION: With a technical success rate of 93% and a clinical success rate of 85% dacryocystoplasty is a non-operative alternative for treatment of epiphora caused by obstructions of the nasolacrimal duct system.

Adult↗

PubMed2002

Antero-medial orbital masses associated with nasopharyngeal carcinoma.

BACKGROUND: Nasopharyngeal carcinoma (NPC) involves the orbits through direct extension to the orbital apex via the cavernous sinus. Anterior orbital masses are very rare with only a few anecdotes in the literature about an anterior spread via nasal cavity or tumour arising de novo from the lacrimal sac. Reactive lymphoid hyperplasia in the orbit has never been reported in association with NPC. MATERIALS AND METHODS: Three cases that presented with antero-medial orbital mass in association with NPC are described. Two of the three cases including one with bilateral orbital mass, had biopsy proven NPC in the orbit and presented with tearing due to lacrimal sac involvement with a palpable mass in the anteromedial orbit. The third case presented with a left antero-medial orbital mass, which on biopsy proved to be a reactive lymphoid hyperplasia. He was detected to have NPC while investigating the orbital mass. All had raised serum levels of IgA against Epstein-Barr virus (EBV). DISCUSSION: The possible mode of spread in our case with bilateral involvement is most likely to be a metastasis, though a microscopic anterior spread through the nasal cavity and nasolacrimal duct could not be ruled out despite there being no evidence of tumour in the original site or nasal cavity. In the second case, the tumour spread from the nasal cavity into the orbit is clearly via the nasolacrimal duct. The third patient presents an interesting association of lymphoproliferative disorder and NPC with Epstein-Barr virus infection. CONCLUSION: Anterior orbital masses involving nasolacrimal duct and lacrimal sac are rare in NPC, but can occur. A rare association of a reactive lymphoid hyperplasia in the orbit with NPC is described.

Adult↗

PubMed1999

A multidisciplinary approach to atypical lacrimal obstruction in childhood.

PURPOSE: This study explores the diagnosis and management of unusual anomalies involving the canaliculi, nasolacrimal duct, nasal cavity, and sinuses in childhood. METHODS: A case series of eight children with lacrimal outflow anomalies ranging from distal nasolacrimal duct cyst formation to persistent dacryocystitis following failed probing or silicone intubation were reviewed retrospectively. Diagnostic studies including intranasal endoscopy and preoperative or intraoperative dacryocystography (DCG) were of value. RESULTS: Treatment modalities included endoscopically guided resection of lacrimal cyst mucosa, endoscopic dacryocystorhinostomy (DCR), and monocanalicular or bicanalicular intubation of the lacrimal outflow system. In our series, endoscopic surgery was well tolerated by all patients with improvement in symptoms. CONCLUSIONS: This initial experience suggests that endoscopic techniques may be useful in the management of atypical lacrimal outflow obstruction in childhood.

Child↗

PubMed2001

The lacrimal fascia redefined.

It has been commonly accepted that the lacrimal fascia is an intact septum, composed of connective tissue, that separates the orbital cavity into a large compartment, which contains the eyeball, and a small compartment, which contains the lacrimal sac and nasolacrimal duct. the septum, however, is not necessarily always intact. We found a circular or oval opening in the lacrimal fascia in 37 of 52 specimens (71.2%) examined. The opening, which we shall refer to as the lacrimal fascial foramen, was located at variable levels in the lacrimal fossa. The lacrimal fascial foramen was buried in fatty tissue through which passed a branch of either the inferior palpebral artery or the infraorbital artery and a vein of the nasolacrimal duct. The clinical implications of the lacrimal fascial foramen in obstruction of the nasolacrimal duct are discussed.

Aged↗

PubMed2001

Nasolacrimal polyurethane stent placement for epiphora: technical long-term results.

PURPOSE: To assess technical problems related to implantation of a polyurethane stent to treat obstructive epiphora, and to assess the long-term patency of the nasolacrimal system. MATERIALS AND METHODS: Fluoroscopically guided placement of a polyurethane nasolacrimal stent was performed in 70 obstructed lacrimal systems of 62 patients with grade 3-4 obstructive epiphora. Follow-up was conducted for 1-20 months (average, 11.3 months). The obstruction was at the lacrimal sac in six systems, at the junction between the lacrimal sac and the nasolacrimal duct in 60 systems, and at the nasolacrimal duct in four systems. The cause of the obstruction was idiopathic in all cases but was probably residual to dacryocystitis. RESULTS: Of these 70 procedures, stent placement was technically successful in 61 systems (87%). On long-term follow-up, 41 (67.2%) stents remained in place, with resolution or clinical improvement, and 18 (29.5%) stents were removed (because of occlusion in 17 systems), with stent malpositioning in the duct in six cases. There were seven cases of malpositioning in all. Statistical analysis was performed to evaluate patency, compare patency in properly positioned stents and malpositioned stents, and establish the relationship between malpositioning and the need for irrigation to maintain stent patency. Of the total 70 stents originally placed, 41 (58.6%) were still in place and functional at long-term follow-up. At 1 year, 73% of properly positioned stents remained patent versus 0% of improperly positioned stents. Median stent patency in the former group was 20 months and was 1 month in the latter group (P = .00002). Eleven percent of properly positioned stents required irrigation versus 57% of incorrectly positioned stents (P = .01). CONCLUSION: After follow-up for 1 year, recurrence of epiphora brought on by stent obstruction was 28%. Early stent blockage and the need for periodic irrigation may be indicative of malpositioning of the stent.

Follow-Up Studies↗

PubMed2006

Cell birth and survival following seasonal periods of cell proliferation in the chemosensory epithelia of red-backed salamanders, Plethodon cinereus.

In addition to the continuous low levels of neurogenesis typical of adult vertebrates to replace damaged chemoreceptor cells, red-backed salamanders (Plethodon cinereus) experience an up-regulation of chemoreceptor epithelial cell proliferation on a seasonal basis. Significantly more cell division occurs in late spring than at any other time of the year, and we investigated the fate and life span of these newly generated cells. We used 5-bromo-2'-deoxyuridine (BrdU) immunocytochemical cell birth dating to examine cell proliferation and cell migration in the main olfactory and vomeronasal epithelia of red-backed salamanders collected in late spring who were allowed to survive for one hour or three, four, 25, 28, 42, 49 and 100 days post-injection. We examined new neuron growth in the vomeronasal and olfactory epithelia using antibodies against Growth Associated Protein-43 (GAP-43), a protein whose synthesis is up-regulated during axon growth. We also tracked apoptosis within both types of chemosensory epithelia using terminal deoxynucleotidyl transferase-mediated nick-end labeling (TUNEL). BrdU-immunoreactive cells were located extensively throughout the vomeronasal epithelia, particularly in the area posterior to the entrance of the nasolacrimal duct, not only after three days of survival, but also all of the longer experimental survival periods as well; BrdU-ir cells within the olfactory epithelia were rarely located after longer survival periods. Salamanders collected in late spring displayed extensive GAP-43 labeling in the vomeronasal epithelia posterior to the entrance of the nasolacrimal duct, indicating a large population of young vomeronasal receptor neurons. Finally, apoptotic cells were evident in this same post-nasolacrimal-duct-area of the vomeronasal organ and in the olfactory epithelium. We suggest that vomeronasal receptor neurons born in late spring function throughout the summer and may be associated with the animals' extensive territoriality during that period.

Analysis of Variance↗

PubMed2000

Distribution of T-cell subsets and immunoglobulin-containing cells in nasal-associated lymphoid tissue (NALT) of chickens.

The present study demonstrated the localization of the T-cell subsets (CD4+ and CD8+) and immunoglobulin (Ig)-containing cells (IgA, IgM, and IgG) in the nasal mucosa and its accessory structures. These lymphoid structures may be compared with nasal-associated lymphoid tissue (NALT) of rats and mice. In the chicken NALT, T-cell subsets were more widely distributed than Ig-containing cells, especially in large lymphoid accumulations restricted to the respiratory mucosa in the nasal cavity and the nasolacrimal duct. These lymphoid accumulations in the mucosa of the nasal cavity and nasolacrimal duct consisted of widely distributed CD8+ cells and deeply aggregated CD4+ cells adjacent to large germinal centers. In these lymphoid accumulations, IgG-containing cells were more frequently observed than IgM- and IgA-containing cells. T-cell subsets, predominantly CD8+ cells were more widely distributed in the duct epithelium of the lateral nasal glands than Ig-containing cells. Moreover, numerous CD8+ cells and a few Ig-containing cells were found in the chicken salivary glands, especially around the orifice of their ducts into the oral cavity. Therefore, it seems likely that the chicken NALT plays an important part in the upper respiratory tract, with a close relationship to the paraocular immune system.

Animals↗

PubMedDate not supplied

Endonasal dacryocystorhinostomy in children.

AIM: To verify whether our results with endonasal endoscopic dacryocystorhinostomy in children with nasolacrimal duct obstruction allow us to consider this technique a valid treatment alternative for children. STUDY DESIGN: clinical with transversal cohort. MATERIAL AND METHOD: Twenty-seven endoscopic endonasal dacryocystorhinostomies were performed in children 2 to 12 years of age for nasolacrimal duct obstruction. Previous probings in all patients were unsuccessful. The technique employed uncinectomy and a small lacrimal sac opening. Follow-up time was 3 months. RESULTS: Twenty-one surgeries (77,8%) were successful. The only complication was silicone prolapse in one case. CONCLUSION: Our results confirm endoscopic endonasal dacryocystorhinostomy as an acceptable and safe method for treating children with nasolacrimal duct obstructions that are resistant to probings.

Child↗

PubMed1994

Lacrimal disease.

Several authors have investigated the success of nasolacrimal duct intubation in children as well as the length of time for tubes to remain in place. The treatment of congenital amniocele with potential for life-threatening septicemia has been investigated. Other topics have included the bacteriology of dacryocystitis emphasizing the risk of endophthalmitis after intraocular surgery, balloon treatment for functional nasolacrimal duct obstruction, anatomical measurements of the lacrimal system relative to intracranial space, and new procedures for punctal stenosis. Diagnostic tests for epiphora and methods of punctal occlusion are evaluated.

Dacryocystitis↗

PubMedDate not supplied

Methicillin-resistant Staphylococcus aureus and methicillin-resistant coagulase-negative staphylococci from conjunctivas of preoperative patients.

To evaluate the incidence and characteristics of carriers of conjunctival methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-resistant coagulase-negative Staphylococci (MRCNS) among preoperative patients at an eye clinic, bacterial growth was studied in 978 conjunctival specimens of 628 preoperative patients without signs of ocular infection. Specimens were evaluated for growth of bacteria on nutrient agar plate, blood agar plate, or chocolate agar plate for 2 days at 37 degrees C. Methicillin resistance was confirmed by disk diffusion and agar screening methods. Susceptibilities of the bacterial strain to ampicillin (ABPC), cefazolin (CEZ), minocycline (MINO), gentamicin (GM), erythromycin (EM), vancomycin (VCM), and ofloxacin (OFLX) were determined by the disk diffusion method. Of the 628 patients (978 eyes), 352 patients (580 eyes) had positive bacterial growth. Among them, 8 (13 eyes) had MRSA growth and 2 (4 eyes) had MRCNS growth. The rate of nasolacrimal duct obstruction was significantly higher in eyes with positive bacterial growth than in eyes with negative growth. Of the 10 patients (17 eyes) with MRSA or MRCNS growth, 8 were older than 80 years, 5 had the same bacterial strains in the anterior nares and throat, 6 had nasolacrimal duct obstruction, 3 had dry eye, and 9 had been recently hospitalized. All 10 bacterial strains were resistant to ABPC, CEZ, and EM, but were sensitive to MINO and OFLX. Five strains were resistant and 5 were sensitive to GM. Two strains examined were sensitive to VCM. After topical antibiotic use for 0.5 to 6 months, the bacterial strains were eliminated. Two of the 17 eyes with MRSA or MRCNS growth did not undergo surgery. No postoperative endophthalmitis developed in 976 of the 978 eyes. Ophthalmologists should be aware that about 50% of preoperative patients without signs of ocular infection may have bacterial growth on the conjunctiva, and that elderly patients with nasolacrimal duct obstruction, dry eye, and recent hospital stays may be carriers of MRSA or MRCNS.

Adolescent↗

PubMed2000

Direct silicone intubation using Nunchaku-style tube (NST-DSI) to treat lacrimal passage obstruction.

PURPOSE: To confirm the usefulness of direct silicone intubation using a Nunchaku-style tube (NST-DSI) for the treatment of lacrimal passage obstruction. METHODS: Included in this retrospective study were 54 cases (45 patients) of adult-onset lacrimal passage obstruction on which NST-DSI was performed. The cases were subdivided into two groups: 29 cases of common canalicular obstruction (the canalicular obstruction group) and 25 cases of nasolacrimal duct obstruction (the duct obstruction group). RESULTS: At the final examination, irrigating fluid passed readily through the lacrimal passage in 39 (72.2%) of the 54 cases. Twenty-two cases (75.9%) were successful in the canalicular obstruction group (29 cases) whereas 17 cases (68.0%) were successful in the duct obstruction group (25 cases). CONCLUSION: NST-DSI is an effective alternative to treat both common canalicular obstruction and nasolacrimal duct obstruction. We regard NST-DSI as the first choice for the treatment of lacrimal passage obstruction.

Adult↗

PubMed2003

The cavernous body of the human efferent tear ducts contributes to regulation of tear outflow.

PURPOSE: To test the hypothesis that the surrounding vascular plexus of the lacrimal sac and the nasolacrimal duct contributes to the regulation of tear outflow. METHODS: Experiments in 30 probands aged between 15 and 37 years were performed in both nasolacrimal systems of each subject by observing with an endoscope the transit time of an applied tear drop containing fluorescein dye until its entry into the inferior meatus of the nose. Four different experiments were performed to determine the median transit time under normal conditions and the influence on transit time of a decongestant drug, a foreign body on the ocular surface, and a decongestant drug applied together with a foreign body on the ocular surface. Comparisons were made between the right and left nasolacrimal system, in males and females, eyeglass wearers and non-eyeglass wearers, and the different experiments and the results statistically analyzed. RESULTS: The tear transit time was independent of side (right or left), gender, or eyeglass wear. It showed great individual variability. Application of a decongestant drug or placement of a foreign body on the ocular surface both prolonged the dye transit time significantly. Application of a decongestant drug simultaneously with placement of a foreign body shortened the dye transit time significantly compared with the effect of the decongestant drug alone but revealed no significant difference compared with application of a foreign body alone. CONCLUSIONS: The cavernous body of the lacrimal sac and nasolacrimal duct plays an important role in the physiology of tear outflow regulation. It is subject to autonomic control and is integrated into a complex neuronal reflex feedback mechanism starting with the dense innervation of the cornea. Moreover, its function can be pharmacologically influenced.

Adolescent↗

PubMed1982

Congenital nasolacrimal system obstruction.

A series of 132 children with congenital nasolacrimal system obstruction was prospectively randomized into three groups to determine the effectiveness of different modes of nonsurgical treatment. Massaging the nasolacrimal sac in a manner that increased hydrostatic pressure and ruptured the membranous obstruction was more effective (with a high degree of statistical significance) than simple massage or no massage at all. Of those children requiring nasolacrimal probing, a high success rate was found with simple obstructions in the nasolacrimal duct. Failure of probing was more common in canalicular obstructions or generally narrow nasolacrimal ducts. Silicone intubation of the nasolacrimal system is an effective way of treating cases not cured by probing.

Dacryocystorhinostomy↗

PubMed1989

The effect of silicone nasolacrimal intubation on epiphora after helium ion irradiation of uveal melanomas.

We evaluated prophylactic silicone tube intubation of the nasolacrimal drainage system prior to helium ion irradiation of uveal melanomas located on the nasal side of the globe. Twelve patients received silicone tubes and were compared to a control group of 12 patients with irradiated nasal tumors without silicone tubes. Symptoms of nasolacrimal duct obstruction and epiphora were evaluated by means of a questionnaire. All patients had nasolacrimal duct irrigation. Patients intubated before irradiation maintained patency (11 of 12), whereas those in the control group did not (zero of 12) (P less than .0014); ten of 12 control patients had closure of both superior and inferior puncta. No significant difference in symptoms of epiphora was observed between the two groups.

Helium↗

PubMed2001

Naso-lacrimal duct balloon dilatation: medium to long term follow-up.

AIM: Subjective patient response to nasolacrimal duct balloon dilatation (dacryocystoplasty) for epiphora due to primary acquired nasolacrimal duct obstruction (PANDO), was sought over the medium to long term. The relevant dacryocystograms were reviewed to assess the relationship between treatment outcome and dacryocystographic appearances. MATERIALS AND METHODS: Sixty-three patients who had, in the preceding 12-month to 8-year period, undergone 102 dacryocystoplasties were sent a postal questionnaire in which subjective response to treatment was requested. Fifty-seven original dacryocystograms were reviewed by the author and the appearances of the lacrimal sacs subjectively assessed. RESULTS: The results showed that in 31% of respondents (total response 48/63, 76%) dacryocystoplasty was ineffective for treatment of PANDO. Treatment failures did not respond to repeat treatment. Sixty-nine per cent of patients considered themselves either cured or improved by the treatment, with a minimal relapse rate during the period studied. The original dacryocystoplasty appearances were unhelpful in predicting treatment response. CONCLUSION: Dacryocystoplasty can be expected to relieve or improve epiphora in 69% patients with PANDO, (incomplete obstruction) and favourable response to treatment is durable in the medium to long term. Repeat treatment is not recommended for those who fail to respond, though may be appropriate for cases of temporary response. The technique is safe and well tolerated. McCullough, K. M. (2001). Clinical Radiology56, 13-16.

Adolescent↗

PubMedDate not supplied

Treatment of acute dacryocystitis in neonates.

Twenty-five newborns with acute dacryocystitis underwent probing of the nasolacrimal duct. All had a resolution of the acute dacryocystitis. Only one continued to have epiphora and had to undergo a subsequent probing with silicone intubation at 9 months of age. All were probed without anesthesia, being mummified and held by nurses while the author performed the probing. Only five were treated with parenteral and topical antibiotics for a week prior to probing while 20 were probed without any prior antibiotic therapy. Additionally, five of six mucoceles of the lacrimal sac which did not resolve in the 1st 2 weeks of life with massage were successfully probed without anesthesia. Four of the five mucoceles had developed an acute dacryocystitis on conservative management. Probing of the nasolacrimal duct in the newborn period is a safe and successful approach for acute dacryocystitis. It is a highly successful procedure for the treatment of acute dacryocystitis with a very low morbidity rate.

Acute Disease↗

PubMed2001

A new groove director for simplified nasolacrimal intubation.

Silicone intubation is commonly performed to maintain patency of the lacrimal drainage system. We describe a new lacrimal groove director, designed to simplify retrieval of the metal Crawford probe with minimal trauma to the nasal mucosa. This instrument can also be used to infracture or medialize the inferior turbinate in both pediatric and adult populations during nasolacrimal duct intubation or external or endoscopic dacryocystorhinostomy.

Dacryocystorhinostomy↗

PubMed1978

Trauma to the lacrimal system in children.

We repaired damage to the lacrimal drainage system in a series of 393 children who had lacrimal obstruction caused by congenital obstruction or facial injuries. Delayed surgery for traumatic obstruction of the nasolacrimal duct in children, including infants, was successful in all cases.

Dacryocystorhinostomy↗