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[Endonasal surgery of posttraumatic dacryocystitis in children].

Posttraumatic dacryocystitis in children are associated with different anatomic defects of the external nose, nasal cavity, eyelids and adjacent tissues. These injuries may complicate conventional endonasal dacryocystorhynostomy. The first step in the treatment of posttraumatic dacryocystitis should be surgical correction of nasal breathing. It is also necessary to apply bone window at least 1.2 cm in diameter followed by formation of the stoma using intubation tube.

Adolescent↗

An orbital abscess secondary to acute dacryocystitis.

An orbital abscess is an ophthalmic surgical emergency that is typically caused by the spread of bacteria from adjacent structures, such as the sinuses, eyelids, or teeth. Although acute dacryocystitis is commonly associated with preseptal cellulitis, it rarely causes orbital infection. Infection of the lacrimal sac will typically localize in the preseptal space because the lacrimal sac lies anterior to the orbital septum. To the authors' knowledge, this is the first report of an intraconal abscess secondary to acute dacryocystitis. The key points in the surgical management of this entity are discussed.

Abscess↗

Previously undiagnosed lymphoma presenting as recurrent dacryocystitis.

Lymphoma occurring in the lacrimal sac is uncommon and usually occurs in patients with known systemic disease. We report the case of an 82-year-old woman who presented with recurrent right dacryocystitis and a mass in the left lower eyelid. The results of the biopsy of the eyelid and fine-needle aspiration of the swelling arising from the lacrimal fossa demonstrated low-grade B-cell non-Hodgkin's lymphoma. This unusual presentation and the histopathological features are described.

Aged↗

Pissarro, dacryocystitis, and the development of modern lacrimal surgery.

The co-founder of French Impressionism, Camille Pissarro, suffered from chronic dacryocystitis for at least fifteen years. This kept him from working for long periods of time, and when he was able to work, influenced his method of painting. Pissarro just missed the modern period of lacrimal surgery, and was treated by conservative methods.

Dacryocystitis↗

Marginal corneal ulcers with acute beta streptococcal conjunctivitis and chronic dacryocystitis.

A 73-year-old woman had right dacryocystitis, intense conjunctival hyperemia and chemosis, marginal corneal ulcers, and abscesses and conjunctival cultures that were positive for beta hemolytic streptococci. A distinct lucid interval separated the peripheral corneal ulcers and infiltrates from the corneoscleral limbus. Gram stain of corneal scrapings revealed polymorphonuclear leukocytes but no bacteria, and corneal cultures were negative for bacteria. The peripheral corneal ulcers and abscesses in our patient with the lacrimal conjunctivitis of Morax clinically resembled the catarrhal ulcers found with staphylococcal blepharitis. A hypersensitivity or toxic reaction to streptococci or their products may have played a role in the development of the marginal ulcers in this patient.

Aged↗

[Nasal fossae hemangiopericytoma revealed by acute dacryocystitis].

We report a 42-year-old woman with a hemangiopericytoma tumor located in nasal fossae, revealed by acute dacryocystitis. Clinical rhinoscopic examination and orbitofacial tomodensitometry showed tumefaction of the lacrimal sac and nasolacrimal duct. We removed the tumor by endonasal surgery. The anatomopathology examination confirmed the diagnosis of hemangiopericytoma. The internal canthus area and the maxillary sinus roof were treated with complementary irradiation.

Acute Disease↗

[Aeromonas hydrophila dacryocystitis. Case report].

The present paper reports on a case of severe dacryocystitis with a dacryolith, caused by Aeromonas hydrophila. On the basis of this case the authors show that a therapy effective in vitro does not lead to elimination of bacteria in all cases, so that further therapeutic considerations are necessary.

Abscess↗

[The pathogen spectrum in neonatal dacryocystitis].

The most common cause of congenital dacryostenosis is the persistence of Hasner's membrane, which in more than 90% of cases perforates during the first 4 to 6 weeks. If no perforation occurs, the tears gather in the lacrimal duct and lacrimal sac until the system is full and an inflammation starts. Formerly, dacryocystitis neonatorum was caused mainly by gram-positive cocci, in particular Streptococcus Pneumoniae; the primary cause now, in consequence of the abuse of antibiotics, are the gram-negative enterobacteriaceae. The most common agent still is Staphylococcus, which is becoming more and more resistant to gentamycin (26.5%). During the past 3 years 64 infants have been examined at the Second Eye Clinic of Vienna University. Smears were taken from the purulent discharge and tested in the usual microbiological way. The study shows the importance of exact diagnosis and specific therapy.

Bacteria↗

Management of acute dacryocystitis in adults.

Acute dacryocystitis frequently is extremely painful and slow to resolve even with systemic antibiotic therapy. We have identified that incision, drainage, and direct application of antibiotics inside the infected sac result in almost immediate resolution of pain and rapid control of infection. This also provides optimal culture material. Twelve consecutive patients treated in this manner had rapid control of the acute infectious process. All eight patients subsequently undergoing dacryocystorhinostomy were fully cured. A total of 58.3% of the patients were infected with gram-negative rods; 50% of the isolates were resistant to most oral antibiotics.

Acute Disease↗

Superior ophthalmic vein thrombosis in a patient with dacryocystitis-induced orbital cellulitis.

A 71-year-old-man presented with chronic left-sided epiphora and a 5-day history of progressive left orbital swelling that had started with a "bump" on the left side of his nose. Orbital CT revealed left-sided preseptal and postseptal inflammation, along with marked thickening of the left superior ophthalmic vein. Orbital MRI with gadolinium enhancement and fat suppression revealed a low-intensity signal in the left superior ophthalmic vein, consistent with a superior ophthalmic vein thrombosis. There was no cavernous sinus involvement. A diagnosis was made of left-sided dacryocystitis-induced orbital cellulitis and superior ophthalmic vein thrombosis. Treatment consisted of intravenous vancomycin, followed by early dacryocystorhinostomy and postoperative intravenous dexamethasone. Anticoagulation was not used. Within 1 week after surgery, the orbital congestion had dramatically improved. Though rare, isolated superior ophthalmic vein thrombosis can be a harbinger of cavernous sinus thrombosis; therefore, early detection is the key to avoiding cavernous sinus thrombosis.

Aged↗

Acute dacryocystitis resembling an infected subcutaneous cystic tumor.

Two cases of acute dacryocystitis are described. Both cases manifested as a painful cystic tumor which enlarged suddenly with swelling of the involved cheek. The condition was quite similar to an infected epidermal cyst. The location of the tumor and an episode of epiphora are the characteristic features of this disease.

Acute Disease↗

Dacryocystitis associated with osteopoikilosis.

We report five members of a family with dacryocystitis associated with osteopoikilosis. The inheritance is autosomal dominant. Review of the literature revealed no other report of this kind of association. Osteopoikilosis must not be considered as a coincidental radiographic finding but as part of a systemic disorder.

Adolescent↗

Dacryocystomaxillorhinostomy for chronic dacryocystitis in a dog.

A 10-year-old female spayed Vizsla had intermittent mucoid ocular discharge from the right eye for 7 years. History, clinical findings, imaging studies, and culture and histopathology results confirmed chronic dacryocystitis with granuloma. A dacryocystomaxillorhinostomy was performed to preserve the functional portions of the nasolacrimal system remaining in this patient, as well as to promote healing of the lacrimal sac granuloma and secondary infection. Complete resolution of the clinical abnormalities was achieved, and the dog remains healthy 3 years postoperatively.

Animals↗

Cannula-probing combined with nasal procedure for dacryocystitis neonatorum.

Between 1973-1976 a total of 2063 cases of dacryocystitis neonatorum have been treated by cannula-probing in our department. In 37 cases the cannula-probing had to be combined with a nasal procedure for opening the closed nasolacrimal membrane: a periosteal elevator was passed into the inferior meatus of the nasal cavity and its tip was rubbed against the tip of the cannula-probe through the imperforate mucosa of the ostium. The patency of the duct was tested by simultaneous syringing. In 34 cases the lacrimal pathway became permanently patient after one nasal procedure and in 2 cases after two operations. This kind of nasal proceudre is indicated: 1) in those cases where the cannula-probing meets with resistance at the ostium; 2) in those cases where control syringing--made while slowly withdrawal the cannulaprobe--is repeatedly unsuccessful at the beginning of the withdrawal.

Catheterization↗

Study of tear film flow and stability in chronic dacryocystitis.

Tear film flow and stability studies were carried out in patients suffering from chronic dacryocystitis by performing Schirmer test-I and tear film break-up-time (BUT) measurements. The results of Schirmer's test corroborated the theory that a reduced out flow of tears causes a compensatory reduced tear secretion. The results of break-up-time confirm the fact that BUT is independent of outflow of tears in patients with epiphora.

Adult↗

Bilateral chronic fungal dacryocystitis caused by Candida dubliniensis in a neutropenic patient.

In recent years, candida species other than Candida albicans have emerged as causes of human candidiasis, particularly in HIV-infected and other immunocompromised people. C. dubliniensis, a recently described species closely related to C. albicans, first isolated from patients with AIDS in Dublin, has been implicated as an agent of oral candidiasis in HIV-positive people. However, it has also been recovered from HIV-negative people, with clinical signs of oral candidiasis and from the genital tract of some women with vaginitis. The first case of bilateral chronic fungal dacryocystitis caused by C. dubliniensis is described in an HIV-negative woman.

Adult↗

Dacryoliths in chronic dacryocystitis and their composition (spectrophotometric analysis).

PURPOSE: To present the findings from histological and chemical analysis of large dacryoliths and correlate them with previous reports. MATERIALS AND METHODS: Dacryoliths were found in 8% of 216 dacryocystorhinostomy operations. In two cases with mild chronic dacryocystitis, large dacryoliths were extracted. The first case was a 42-year-old male with three dacryoliths in a lacrimal sac, presenting diverticulum-like formations, the second was a 22-year-old woman with one dacryolith at the entrance of the nasolacrimal duct. Chemical analysis was based on atomic absorption spectrophotometry (F.AAS) and on atomic emission spectrometry (AES). Light histological examination was also done. RESULTS/CONCLUSIONS: The findings were the same in both cases. Histological examination revealed amorphous organic material, and limited areas with the characteristics of calcium salt depositions. Chemical analysis showed mainly organic material with only minimal inorganic material. Explanations are offered about the formation of these dacryoliths.

Adult↗