SEARCH · PubMed Health

Results for “NASOLACRIMAL DUCT”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 595 records · Page 33Linked to original sources

PubMedDate not supplied

Three-dimensional rotational dacryocystography for imaging of the lacrimal draining system and adjacent anatomical structures.

PURPOSE: A three-dimensional (3D) rotational angiography system was used to perform 3D dacryocystography (3DRD) as an adjunct to the conventional dacryocystography assisted by digital subtraction angiography (DSA). METHODS: In 15 patients with severe epiphora, 3DRD was performed after inconclusive results from DSA-assisted dacryocystography. RESULTS: 3DRD was technically feasible and well tolerated in all 15 cases. In 5 out of 15 patients, 3DRD, in contrast to DSA-assisted dacryocystography, distinguished clearly between stenotic lesions of the canaliculi, lacrimal sac or nasolacrimal duct. In 10 cases, the simultaneous display of tear ducts and adjacent structures of the nasal cavity provided critical anatomical information for decision making between endoscopic and open dacryocystorhinostomy. CONCLUSIONS: 3DRD is technically feasible and adds important information to conventional DSA-assisted dacryocystography.

Aged↗

PubMed1994

Endoscopic endonasal dacryocystorhinostomy: results in 56 patients.

Fifty-six patients with a complete stenosis of the nasolacrimal duct were treated by endoscopically controlled intranasal dacryocystorhinostomy according to West. Forty-four patients had idiopathic stenosis and 12 had posttraumatic scarring. Revision surgery was done in 11 of these 56 cases (8 patients with a previous external Toti procedure, and 3 patients with previous endonasal surgery). Altogether, 95% of the patients were symptom-free (86%) or felt improved (9%) postoperatively. Surgical revision was successful in 82%. Of patients with an "idiopathic" stenosis, 84% were healed and an additional 11% were improved. The success rate in the 12 patients with posttraumatic stenosis was 92%. Endoscopic duct surgery is a highly successful procedure with a low complication rate, the worst complication being persistence of symptoms.

Aged↗

PubMedDate not supplied

Endoscopically assisted balloon dacryocystoplasty and silicone intubation versus silicone intubation alone in adults.

PURPOSE: To compare the success rate of endoscopically assisted balloon dacryocystoplasty (DCP) and silicone intubation (DCP-SI) with endoscopically assisted silicone intubation alone (SI) in adults with incomplete nasolacrimal duct (NLD) obstruction. METHODS. In a retrospective nonrandomized comparative case series, 62 eyes of 55 adult patients with incomplete NLD obstruction underwent endoscopic probing and either SI (n=39 eyes) or DCP-SI (n=23 eyes) under general anesthesia. The last follow-up examination included diagnostic probing and irrigation if there was not success. Success was defined as disappearance of the symptoms and failure as partial improvement or absence of improvement at last follow-up. RESULTS: Patients ranged from 20 to 85 years of age (mean: 60.93, SD: 15.60). Tubes were removed between 6 and 20 weeks (mean: 7.49, SD: 2.25) postoperatively. Follow-up ranged from 6 to 63 months (mean: 14.60, SD: 10.33). Success rate of the eyes with SI (21/39, 53.84%) and DCP-SI (14/23, 60.86%) were not statistically different (p=0.60). Complications included slight nasal and canalicular bleeding in almost all eyes in both groups which was easily controlled, slit punctum in four eyes with bicanalicular intubation (4/50, 8%), and monocanalicular tube lost in three eyes prematurely. CONCLUSIONS: Success rate of endoscopic DCP-SI had no statistically significant difference from silicone intubation alone in treatment of incomplete NLD obstruction in adults.

Adult↗

PubMed2002

Nasolacrimal drainage system obstruction from radioactive iodine therapy for thyroid carcinoma.

Ophthalmic complications of (131)I therapy, including ocular dryness, have been recently investigated and described. However, nasolacrimal drainage system obstruction (NDSO), complicating (131)I therapy, has not been previously well appreciated or characterized. One of our patients developed bilateral complete nasolacrimal duct obstruction after (131)I therapy that prompted awareness of this potential complication. Over 16 months, 423 patients with epithelial-derived thyroid cancer were provided routine clinical care; 390 of these patients had received (131)I ablation or therapy, and 10 patients subsequently reported epiphora. All had evidence of NDSO disease after a mean cumulative (131)I dose of 17,279 +/- 2,923 MBq (467 +/- 79 mCi), with a mean individual (131)I dose of 6,660 +/- 555 MBq (180 +/- 15 mCi). Symptoms appeared 6.5 +/- 1.4 (range, 3-16) months after the last (131)I dose, whereas the mean time from symptom onset to correct diagnosis was 18 +/- 5 months. A causal relationship between (131)I administration and NDSO is strongly suspected. Patients reporting epiphora should be evaluated promptly by an oculoplastic surgeon.

Adolescent↗

PubMed1987

Wound necrosis following dacryocystorhinostomy in patients with Wegener's granulomatosis.

Two patients with Wegener's granulomatosis underwent dacryocystorhinostomy (DCR) for nasolacrimal duct obstruction and epiphora. Wound necrosis occurred in each individual with the formation of a nasal-cutaneous fistula. A pedicle flap was the treatment of choice in one case, while direct closure of the necrotic incision site and high-dose steroid therapy was used in the other. Both did well with complete wound healing. The tearing persisted in one and resolved in the other. Dacryocystorhinostomy should be avoided whenever possible in patients with Wegener's granulomatosis, and steroid dosage should be increased if surgery is necessary in the presence of active inflammation.

Adult↗

PubMed1997

Dacryocystectomy: surgical indications and results in 25 patients.

The main indication for dacryocystectomy (DCT) is excision of lacrimal sac tumors. DCT may be considered less invasive than dacryocystorhinostomy (DCR) because lacrimal bone and nasal mucosa are not violated. To determine other indications for DCT, we performed a retrospective review of all patients who underwent DCT from the Oculoplastics Division, Department of Ophthalmology, UMD-New Jersey Medical School from July 1983 through July 1994. Patients with lacrimal sac tumors were excluded from the study. All 25 patients in the study demonstrated complete nasolacrimal duct obstruction (NLDO) and dry eye with minimal preoperative complaints of tearing. Nine of 25 patients also had systemic medical problems making them at medical risk for local anesthesia with monitored sedation. Four of 25 patients had underlying medical conditions (ocular cicatricial pemphigoid [OCP], Crohn's disease, and systemic lupus erythematosus) that might predispose them to nasal scarring after standard DCR. None of the 25 patients required secondary hospital admission and no patient demonstrated or complained of significant tearing that affected daily function after DCT. Although DCR is the standard for improving lacrimal outflow, we conclude that DCT is a useful alternative to it in selected patients with underlying dry eye and other medical conditions.

Aged↗

PubMed1996

Balloon dacryocystoplasty: an alternative treatment for obstructed tear ducts.

Twenty-two patients with severe epiphora due to relative (n = 13) or absolute (n = 9) stenoses of the nasolacrimal duct were treated by means of radiologically guided balloon dacryocystoplasty. The recanalization was performed with a steerable microguide wire with flexible tip, which was advanced through the lacrimal draining system and manipulated out of the nasal cavity. A 3-mm PTA balloon was then introduced from the nasal site. In 20 of 22 cases the procedure was technically successful. Dacryocystography proved a normal lumen in 9 of 20 patients and an improvement without impairment of flow in another 8 cases. Two months after dilation a clear regression of epiphora could be demonstrated in 17 of 20 patients. The procedure was complicated by the occurrence of 2 reobstructions within the first 3 months; other serious side effects were not observed.

Adult↗

PubMedDate not supplied

Tear lipid layer interference changes after dacryocystorhinostomy.

PURPOSE: Specular images of the tear film in the central cornea were examined in patients with nasolacrimal duct obstruction to observe changes before and after dacryocystorhinostomy (DCR). METHODS: We observed the specular images in 4 patients (5 eyes) by a noncontact observation device and recording system. Observed patterns were classified into five grades. The specular images and tear meniscus height (TMH) were recorded. RESULTS: Three of the 4 eyes with TMH values over 0.4 mm before DCR showed decreased TMH postoperatively. The 1 eye with a TMH value of 0.2 mm showed no change after DCR. Using specular images, 4 eyes were classified grade 1 or 2, and 1 eye was classified grade 4 before DCR. After DCR, the 5 eyes were classified as grade 3 or grade 4. CONCLUSION: The results indicated that the eye after DCR has a thicker lipid layer than the eye before DCR.

Aged↗

PubMed1996

Lipogranuloma: a preventable complication of dacryocystorhinostomy.

This report describes the unusual occurrence of lipogranuloma at the incision site of dacryocys-torhinostomy. Four patients had soft cystic masses after external dacryocystorhinostomy for acquired nasolacrimal duct obstruction. This was attributed to the antibiotic ointment vehicle that coated the petroleum jelly-impregnated gauze placed intranasally to prevent epistaxis. Postoperatively, all four patients had an encapsulated cystic mass within 3 weeks. Three of the masses were excised under local anesthesia and one was aspirated. None of the masses recurred.

Adult↗

PubMed1991

Acute dacryocystic retention cured by inferior turbinate infracturing.

A 30-year-old man with recurrent acute dacryocystic retention had successful infracturing of the inferior turbinate bone in association with probing of the lacrimal outflow system. Enlargement of the inferior nasal meatus by fracturing the turbinate is easy to do and would be indicated before recommending a dacryocystorhinostomy in cases of acute dacryocystic retention in which the causative cast is difficult to eliminate even by large probes that can be passed down the nasolacrimal duct.

Acute Disease↗

PubMed2006

Endoscopic management of pediatric nasolacrimal anomalies.

Developmental anomalies of the nasolacrimal drainage system typically manifest early in childhood with epiphora and occasionally infection. Although the majority of cases of congenital nasolacrimal obstruction resolve spontaneously with conservative medical management, certain anomalies require operative intervention. Included in this latter group are dacryocystoceles or nasolacrimal duct cysts. The application of endoscopic sinus surgical techniques to children with persistent symptomatic nasolacrimal obstruction provides an alternative to external dacryocystorhinostomy that appears to be equally efficacious and concurrently allows for the potential correction of any predisposing intranasal pathology. Endonasal endoscopic dacryocystorhinostomy is best performed as a joint otolaryngologic-ophthalmologic procedure.

Child↗

PubMed1996

Holmium laser canaliculoplasty.

Thirty canaliculi of 18 patients with complete or nearly complete canalicular obstruction were subjected to laser canaliculoplasty as a substitute for the standard Jones-type bypass conduct. Etiologies for the obstruction included congenital lacrimal system atresia, eyelid trauma, scarring following previous lacrimal surgery, and chronic inflammatory fibrosis. The procedure utilized a holmium laser delivered via a 1,000 mu optical fiber to cut a 1-mm channel from the punctum into the lacrimal sac. In nine eyes, this procedure was combined with a surgical dacryocystorhinostomy (DCR) for concurrent lower nasolacrimal duct obstruction. Silicone stents were left in place for 6 months postoperatively. Follow-up data were available for 28 canaliculi of 17 patients. Moderate or better improvement in symptomatic epiphora and evidence of canalicular patency to drainage was seen in 16 of 28 (57%) treated canaliculi, and significant improvement was recorded in 12 of 28 (43%). Although these figures are lower than those obtainable after repair of small areas of focal canalicular stenosis or obstruction, the procedure is superior to any previous attempts at reconstruction of extensive obstructions, short of placement of a Jones tube. When successful, this procedure offers re-establishment of a near normal physiologic system, and avoids the complications of and patient dissatisfaction associated with a Jones tube.

Adult↗

PubMed2003

Cell-specific expression of CYP2A5 in the mouse respiratory tract: effects of olfactory toxicants.

We performed a detailed analysis of mouse cytochrome P450 2A5 (CYP2A5) expression by in situ hybridization (ISH) and immunohistochemistry (IHC) in the respiratory tissues of mice. The CYP2A5 mRNA and the corresponding protein co-localized at most sites and were predominantly detected in the olfactory region, with an expression in sustentacular cells, Bowman's gland, and duct cells. In the respiratory and transitional epithelium there was no or only weak expression. The nasolacrimal duct and the excretory ducts of nasal and salivary glands displayed expression, whereas no expression occurred in the acini. There was decreasing expression along the epithelial linings of the trachea and lower respiratory tract, whereas no expression occurred in the alveoli. The hepatic CYP2A5 inducers pyrazole and phenobarbital neither changed the CYP2A5 expression pattern nor damaged the olfactory mucosa. In contrast, the olfactory toxicants dichlobenil and methimazole induced characteristic changes. The damaged Bowman's glands displayed no expression, whereas the damaged epithelium expressed the enzyme. The CYP2A5 expression pattern is in accordance with previously reported localization of protein and DNA adducts and the toxicity of some CYP2A5 substrates. This suggests that CYP2A5 is an important determinant for the susceptibility of the nasal and respiratory epithelia to protoxicants and procarcinogens.

Animals↗

PubMed1998

[Dynamic magnetic resonance dacryocystography using half Fourier single shot fast spin echo sequence].

Dynamic magnetic resonance dacryocystography (MRD) was implemented using 1.5T superconductive imager with a standard head coil. Prior to MRD, a pair of polyethylene microcatheters were inserted into the lower lacrimal canaliculi. Injecting a mixture of 6 ml of saline and 4 ml of xylocaine (0.5%) as a substitute for contrast medium, repeated measurement of thick section heavily T2 weighted image using half Fourier single shot fast spin echo (SSFSE) sequence was performed. MRD could well depict the pathologies of the lacrimal sac and the lacrimal duct in five cases of epiphora. It pinpointed the level of lacrimal duct obstruction, which was confirmed by both X-ray dacryocystography and intraoperative findings. Dynamic MRD is a reliable method of diagnosing nasolacrimal duct obstruction without using ionizing radiation or chemical contrast medium.

Aged↗

PubMed1997

CT-anatomy of the nasolacrimal sac and duct.

Recent developments in ophthalmology such as balloon dilatation, stent implantation, laser therapy and endoscopy of the lacrimal drainage system raise the need for a detailed anatomical knowledge of this system. In this study morphometric measurements of the lacrimal drainage system were performed with thin-section axial computed tomography (CT) examinations in 147 patients with no signs of pathology related to the lacrimal drainage system. The mean length of the nasolacrimal duct measured 11.2 +/- 2.6 mm (range: 6-21 mm), the narrowest diameter was 3.7 +/- 0.7 mm (range: 2-7 mm). The mean length of the nasolacrimal sac was 11.8 +/- 2.5 mm (range: 6-18 mm). The width of the nasolacrimal sac did not exceed 4 mm unless filled with air. In 43 (29.3%) of the subjects air was visible within the nasolacrimal sac or duct. The knowledge of the morphometry of the lacrimal drainage system enables the ophthalmologist to plan intervention on the lacrimal drainage system precisely and avoid unnecessary manipulations.

Female↗

PubMedDate not supplied

External dacryocystorhinostomy combined with mucosal grafting and magnetic resonance imaging.

PURPOSE: To facilitate understanding of the use of magnetic resonance imaging (MRI) in nasolacrimal obstructive diseases and to determine the indication for external dacryocystorhinostomy (DCR) combined with mucosal grafting. METHODS: We retrospectively studied the correlation between MRI images and surgical findings in 13 consecutive patients with swollen lacrimal sacs because of obstruction of the nasolacrimal duct or lacrimal sac. They were treated at the Kagoshima University Hospital between June 1999 and May 2001. RESULTS: A simple procedure of external DCR was performed in 9 cases, and a procedure combined with mucosal grafting was performed in 4 cases (age range, 51-88 years). Surgical findings in the fibrous region of the lacrimal sac corresponded to the hyperintense signal on MRI T(1)-weighted (T1W) images, more remarkably after enhancement. Surgical findings in the granulomatous sac and proteinaceous contents corresponded to the isointense areas on T2W images. Cases with thin sac were treated by standard DCR, whereas cases with thick, fibrous and granulomatous sac were treated by external DCR combined with mucosal grafting. CONCLUSIONS: The MRI images provide a useful preoperative determination for indications of external DCR combined with mucosal grafting.

Aged↗

PubMed2006

Long term follow up of nasolacrimal intubation in adults.

BACKGROUND/AIMS: The authors have previously reported a short term mean 15 month follow up of nasolacrimal intubation in adults. The effectiveness of this procedure for long term (mean 78 months) control of epiphoria is assessed here. METHODS: 65 eyes from 40 patients who underwent nasolacrimal intubation were followed. Mean age at intubation was 59.2 years. The mean follow up period was 6.2 years. The results were based on long term symptomatic improvement. RESULTS: Complete long term resolution of symptoms was reported in 50.7%. A partial improvement was reported in 38.5%, and no improvement in 10.7%. A better outcome was associated with a canalicular than nasolacrimal duct obstruction. On long term follow up 16.9% required dacrocysto-rhinostomy (DCR). CONCLUSION: Nasolacrimal intubation, a minimally invasive procedure is successful in the long term control of epiphora. Selection of patients with canalicular duct obstruction gives higher success rates with fewer patients subsequently requiring the DCR procedure.

Adult↗

PubMed1986

Incidence of conjunctival colonization by bacteria capable of causing postoperative endophthalmitis.

Increased awareness of the range of pathogens capable of causing postoperative endophthalmitis prompted a study of the conjunctival flora in 100 patients admitted for intraocular surgery. Bacteria capable of causing endophthalmitis were present in 74% of these patients, a much higher proportion than previously documented. No correlation was found with blockage of the nasolacrimal duct.

Adult↗