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Dacryoscintigraphy in children.

Dacryoscintigraphy was performed in 34 pediatric patients aged between 13 months and 20 years. Twenty-six were 12 years of age or younger. The study is easy to perform and provides useful information regarding the function of the nasolacrimal system. The radiation dose to the lens of the eye, estimated to be 4-14m rads/100 uCi of technetium pertechnetate, is considerably less than that of a skull x-ray or dacryocystography. Of the 74 nasolacrimal systems studied, the findings were in agreement with the clinical observations and other methods of testing in 63. In nine instances, the findings altered the clinical management while the results were inconclusive or misleading in the remaining two. Dacryoscintigraphy was found to be a useful physiological test in the evaluation of children with epiphora.

Adolescent↗

Modified Kinosian dacryocystorhinostomy: a review of 122 cases.

A consecutive series of 122 dacryocystorhinostomies is reviewed, and a surgical technique which preserves the anterior lacrimal crest and eliminates the need to create mucosal flaps is described. The success rate of this simplified technique is 89%. The success rate rises to 94% following secondary revisions. This is comparable to more complicated procedures. Canalicular and common punctal stenosis are not found to be contraindications to dacryocystorhinostomy for obstruction of the nasolacrimal duct but do lower the success rate. Eighty-one percent of patients with concomitant canalicular disease and nasolacrimal duct obstruction were cured by dacryocystorhinostomy with silicone intubation. A success rate of 98% was achieved in patients without preoperative canalicular disease.

Aged↗

[Role of sophisticated radiological technics in the diagnosis of lacrimal fistulas].

Lacrimal fistulae are rare and not well known by radiologists. Four cases are illustrated, two congenital (a skin-canaliculous and a canaliculous-palpebral fistula) and two acquired (a rare case of sac-orbital fistula and a canaliculous-palpebral fistula arisen during dacryography). Fistulae are to be distinguished from pedunculated lacrimal diverticulous of which an interesting and rare case is presented. After a careful examination of the pathogenesis and symptomatology of lacrimal fistulae the authors agree that only macrodacryography carried out by means of sophisticated techniques (seriography, magnification, subtraction) enables a precise demonstration of the originating point, of the course and outlet (cutaneous and internal) and provides therefore indispensable data for surgery.

Adolescent↗

[Keratoconjunctivitis sicca caused by denervation of lacrimal gland (author's transl)].

An irreversible, unilateral keratoconjunctivitis sicca developed in a healthy 16-year-old female patient due to traumatic denervation of the lacrimal gland after oto-basal skull fracture with reversible complete peripheral facial paralysis, the corneal sensitivity remaining normal. This observation and other reports on keratoconjunctivitis sicca caused by isolated lacrimal gland insufficiency indicate the physiological importance of the main lacrimal gland as indispensable part of the secretory tear system.

Child↗

Treatment of the lacrimal excretory system after resection of medial canthal and eyelid tumors.

A simplified method of lacrimal excretory system repair is presented. If part of a canaliculus is resected during removal of an eyelid tumor, the remaining section of the canaliculus can be exteriorized to the lacrimal lake. A silicone tube is threaded into the canaliculus and allowed to remain in place for one to two weeks. If both canaliculi and the common canaliculus are removed during resection for a medial canthal tumor, a silicone tube can be threaded into the nasolacrimal duct and brought out the area of the medial canthal angle. Conjunctiva which is wrapped around the tube can then form a new drainage canal into the remainder of the lacrimal excretory system.

Adult↗

[Malignant blue nevus in Ota's nevus].

A 21-year-old Caucasian woman with congenital nevus of Ota developed a subcutaneous tumor below the lacrimal sack within the area of discoloration. The tumor, located subcutaneously, has been present for 4 years. Histologically, parts of the tumor showed neuroid structures as well as those like cellular blue nevus. In one part, however, malignant transformation features could be found.

Adult↗

Miniprobe for lacrimal sac temperature measurement.

The hypodermic probe is presented as a portable and easily used instrument for assessing the temperature within the lacrimal drainage system. Its size makes it practical for clinic or office use. It is also acceptable to the patient and may be performed immediately prior to lacrimal syringings. We suggest that lacrimal sac temperatures may be readily measured and are helpful in assessing the degree of inflammation or the presence of mucus in the lacrimal sac.

Adult↗