PubMed Health⌕ Search

SEARCH · PubMed Health

Results for “LACRIMAL APPARATUS”

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 163 records · Page 9Linked to original sources
PubMed1979

Long-term review of injuries to the lacrimal drainage apparatus.

A series of 57 patients with injuries to the proximal lacrimal drainage apparatus was reviewed to assess the long-term sequelae. The lower canaliculus was involved in 33 patients, the upper in ten, and both upper and lower in twelve, while the common canaliculus and lacrimal sac were each involved in one patient. It was found that either the upper or the lower canaliculus could cope independently with basal lacrimal secretions and that patients with at least one canaliculus intact had no symptoms under normal conditions. In seven patients with lower canalicular lacerations it was found that spontaneous functioning fistulae had developed nasal to the site of canalicular obstruction. The management of canalicular lacerations is discussed and it is recommended that the function of an intact canaliculus should not be jeopardized by surgical manipulations in an attempt to repair a damaged fellow canaliculus.

Adolescent↗
PubMedDate not supplied

Clinical features and management of tumors affecting the lacrimal drainage apparatus.

PURPOSE: To report the clinical features of a series of patients with lacrimal drainage apparatus tumors and present guidelines for management based on histopathology. METHODS: A non-comparative retrospective chart review of the clinical, imaging, and pathologic findings of 37 patients presenting to four regional orbital surgery departments with tumors affecting the lacrimal drainage apparatus between 1990 and 2004. RESULTS: There were 37 patients, of whom 62% were male. The mean age at referral was 54 years. Epiphora, a palpable mass, and dacryocystitis were the most common presentations. Two thirds of the tumors were epithelial, with carcinomas being the most frequent (38%), followed by papillomas (27%). Lymphomas were the most common nonepithelial malignancy (30%). Epithelial tumors were more common in men (87%), whereas lymphomas were more common in women (57%). Treatment modalities included surgery, in addition to radiotherapy and/or chemotherapy and immunotherapy. Mean follow-up was 38 months. Thirty-three patients (89%) remain alive without evidence of disease and 4 patients died of recurrence and/or metastases. CONCLUSIONS: Lacrimal drainage apparatus tumors require careful initial management to ensure adequate local and systemic disease control. Atypical mucosa encountered during dacryocystorhinostomy should be biopsied and small papillomas or pedunculated tumors excised and analyzed with frozen sections. If a diffuse or infiltrative mass is encountered, it should be biopsied and managed on the basis of histopathology and extent of disease. Lymphomas should be treated according to protocols, whereas noninvasive carcinoma and extensive papillomas require complete excision of the system. Invasive disease requires en bloc excision. Long-term follow-up is essential for early detection of recurrence.

Adult↗
PubMed1993

Disorders of the lacrimal system apparatus.

Epiphora, or excess tearing, is a common problem in infants. The most frequent etiology of this disorder is a nasolacrimal duct obstruction. There are other conditions, however, some of which can be serious, which can cause tearing. Infections of the eyelids and conjunctiva, an undiscovered foreign body, and congenital glaucoma are among the conditions that must be ruled out when any child presents with excessive tearing.

Child↗
PubMed1985

CT of the inferomedial orbit and the lacrimal drainage apparatus: normal and pathologic anatomy.

The normal and pathologic CT anatomy of the lacrimal drainage apparatus was examined during study of the orbits, nasal cavity, and paranasal sinuses in 100 patients with a variety of clinical complaints related to the inferomedial orbit. The bony lacrimal fossa, the nasolacrimal canal, and the fluid- or air-filled lacrimal sac and nasolacrimal duct were readily recognized in all cases. The lacrimal fossa and sac are found at the inferomedial orbit and are preseptal structures. Cystic expansion of the lacrimal sac (dacryocystitis) may mimic orbital abscess clinically; however, the radiographic recognition of a cystic, peripherally enhancing mass centered at the lacrimal fossa should exclude postseptal abscess and permit more conservative therapy. Obstruction or invasion of the drainage apparatus by tumor, infection, or posttraumatic scarring is readily depicted by CT. Sagittal/coronal images reformatted from thin transverse axial sections are often useful in defining the origin of an inferomedial orbital mass and its relation to the lacrimal sac when clinical studies and axial CT findings are equivocal.

Adult↗
PubMed2003

Experience with bicanalicular intubation of the lacrimal drainage apparatus combined with conventional external dacryocystorhinostomy.

AIM: The aim of this study was to assess the success rate of bicanalicular intubation of lacrimal drainage apparatus in chronic dacryocystitis patients who were at high risk of failure of surgery of dacryocystorhinostomy. MATERIAL AND METHODS: A total of 24 patients with chronic dacryocystitis (25 eyes) including 11 males and 13 females (age range 3-80 years) having high risk factors of failure of dacryocystorhinostomy were enrolled. Factors such as previous attacks of acute dacryocystitis, trauma in lacrimal sac region, previously failed dacryocystorhinostomies, formation of false passages in the lacrimal drainage apparatus were considered. Conventional dacryocystorhinostomy followed by bicanalicular intubation of the lacrimal drainage apparatus with Jain metal silicone the lacrimal intubation tube (20-23 gauge) was performed in all these patients. The patients were followed up at weekly intervals for two months, at 6 months and at 1 year post surgery. RESULTS: A total of 25 eyes in 24 patients (including 11 males and 3 females) were operated upon using the technique of bicanalicular intubation of lacrimal drainage apparatus with conventional external dacryocystorhinostomy. The procedure was successfully performed in 22 out of the 25 eyes. Perioperative complications included punctual damage due to recurrent attempts at passing these probes in 2 patients and mild damage to nasal mucosa in 5 patients. The majority of patients did not experience any untoward symptoms from these silicone tubes. However, in three eyes there was felt a mild foreign body sensation and two patients had chronic conjunctival erythema. The tubes could not be retained in two of these three eyes. Additionally, in one eye there was spontaneous extrusion of tubes whilst sneezing 3 months after surgery. All these three eyes had a recurrence of symptoms due to non-retention of the tubes and needed re-operation. On average the tubes were retained for a period of six months before they were spontaneously extruded or removed. Fifteen patients retained the silicone tubes for more than 1 year. The procedure gave a success rate of 76% (19/25 eyes) and these were the eyes in which the tubes had been retained for more than 6 months. The success was not influenced by the age or sex of patient, laterality of eye, aetiology of chronic dacryocystitis, or evidence of bony deformity or abnormality of the sac. CONCLUSIONS: Bicanalicular intubation for lacrimal drainage system is a simple, inexpensive and straight forward adjunct to conventional external dacryocystorhinostomy. The procedure is strongly indicated for patients with chronic dacryocystitis who are at high risk of surgical failure. Carefully performed, it gives a 76% success rate and is not influenced by the different variables examined.

Adolescent↗
PubMedDate not supplied

Stenoses and functional disorders of the lacrimal drainage apparatus. Radiological examination.

The diagnosis of epiphora can be greatly aided by a special radiologic technique, performed during bilateral injection of contrast medium into the lacrimal passages and utilizing seriography, magnification and image subtraction. The authors describe the technique, discuss the interpretation of the various radiologic patterns, and stress the importance of this method for evaluating inflammation, stenoses and functional alterations of the lacrimal passages.

Dacryocystitis↗
PubMed1998

Topical contrast-enhanced CT and MR dacryocystography: imaging the lacrimal drainage apparatus of healthy volunteers.

OBJECTIVE: The purpose of this study was to evaluate the feasibility of administering topical contrast material during helical CT dacryocystography and topical saline solution during MR dacryocystography to reveal the lacrimal drainage apparatus. SUBJECTS AND METHODS: Fourteen healthy volunteers underwent helical CT dacryocystography, MR dacryocystography, or both. Eight of the 14 subjects underwent both techniques; three subjects underwent MR dacryocystography, and three subjects underwent CT dacryocystography. Images were evaluated by two radiologists for degree of visualization of components of the lacrimal drainage apparatus. Each volunteer was questioned about the relative discomfort of contrast material and saline solution administration. RESULTS: The lacrimal drainage system was seen on both CT dacryocystography and MR dacryocystography. CT dacryocystography allowed two-dimensional and three-dimensional reconstructions on which adjacent bone anatomy could be seen. The MR dacryocystography two-dimensional reconstructions and maximum intensity projections also showed the drainage apparatus. However, smaller drainage structures were more consistently seen on CT dacryocystography than on MR dacryocystography. Saline solution was more comfortable than contrast material. CONCLUSION: CT dacryocystography and MR dacryocystography reproducibly and non-invasively revealed the lacrimal drainage apparatus and allowed a better physiologic examination than cannulation dacryocystography. MR dacryocystography can be performed without administration of ionizing radiation or contrast material, but this technique cannot show adjacent bone anatomy and less consistently showed the smaller drainage structures than CT dacryocystography.

Contrast Media↗
PubMedDate not supplied

Combined external-endonasal approach for complete excision of the lacrimal drainage apparatus.

PURPOSE: The purpose of this study was to describe a new surgical technique for the complete excision of the lacrimal drainage apparatus (LDA) that combines external and endoscopic approaches. METHODS: This study involved a noncomparative, retrospective chart review of the clinical and pathological findings of four patients presenting with LDA papillomas who underwent a combined open and endonasal excision of the lacrimal system. RESULTS: Of the four patients, three were male. The mean age at referral was 41 years, and all cases were unilateral. Histopathology revealed two transitional cell papillomas, one squamous cell papilloma, and one combined transitional/squamous papilloma. Epiphora and an external lesion were the main complaints at presentation. Nasolacrimal duct obstruction was present in all four patients. Papilloma virus infection was suggested in two cases and was confirmed in the only patient who had recurrence. CT identified a solid enhancing mass in two cases. The surgical approach in all cases was performed with the patient under general anesthetic supplemented with infiltration of local anesthesia with vasoconstriction. The lacrimal sac was exposed as per an external dacryocystorhinostomy with biopsy collection from the lacrimal sac lumen to confirm the diagnosis prior LDA excision. The superior aspect of the LDA was isolated by using lacrimal probes in each canaliculus to stabilized parallel incisions and careful dissection toward the common canaliculus until they met the medial aspect of the lacrimal sac. The sac was then separated from the periosteum from the medial orbital wall, using sharp dissection. Finally, an endoscopic dissection of the lower end of the nasolacrimal duct released the most inferior aspect of the LDA, allowing the surgeon to pull and excise the complete system from the external wound. CONCLUSIONS: Extensive LDA papillomas required complete excision of the drainage system to prevent recurrence and/or malignant transformation. The use of a combined approach through an open excision of the superior part of the LDA in conjunction with the direct manipulation of the nasolacrimal duct guided by the nasal endoscope facilitates the complete excision of the system for extensive benign lesions.

Adult↗
PubMedDate not supplied

En bloc excision in malignant tumors of the lacrimal drainage apparatus.

PURPOSE: To describe the surgical technique and results of en bloc excision in a series of patients with extensive malignant tumors of the lacrimal drainage apparatus (LDA). METHODS: This was a noncomparative, retrospective chart review of the clinical and pathologic findings of 11 patients presenting with a malignant tumor affecting the LDA who underwent en bloc excision of the lacrimal system. RESULTS: Of the 11 patients, 7 were male. The mean age at presentation was 58 years (range, 39 to 81 years), and all cases were unilateral. Histopathology revealed 4 squamous cell carcinomas, 3 transitional cell carcinomas, 2 mucoepidermoid carcinomas, and 2 melanomas. Epiphora and a mass were the most common presentations. An external lesion could be identified in 4 cases. Irrigation of the lacrimal system revealed nasolacrimal duct obstruction in 2 cases and common canaliculus obstruction in another 2 patients. The entire LDA and surrounding bony tissues were excised through a lateral rhinotomy approach. Adjuvant radiotherapy was given in 4 cases. Nine patients remain alive and well after a mean follow-up of 2 years (range, 6 months to 7 years). Three cases showed distant disease and 2 patients died of metastatic melanoma involvement. CONCLUSIONS: The use of en bloc excision as a radical treatment to remove the complete LDA and surrounding bony structures affords good local tumor control and may provide the best opportunity for enhanced patient survival.

Adult↗
PubMed1990

[The diagnostic results in lacrimation pathology using a dacryoscintigraphic method].

Dacryoscintigraphy used for diagnosing the lacrimal apparatus pathology in 27 patients has revealed the advantage of this method over the previously used methods (the West's color test, X-ray contrast dacryoscintigraphy, diagnostic washing of tear passages) having a number of shortcomings. Of a special value is dacryoscintigraphy for diagnosing functional disturbances in the lacrimal apparatus. However, a full information about the state of tear passages can be received only by complex usage of all the mentioned methods.

Humans↗
PubMed2003

Blockage of the lacrimal drainage apparatus as a side effect of docetaxel therapy.

BACKGROUND: The current study was conducted to report the severity and management of canalicular and nasolacrimal duct stenosis as a side effect of docetaxel therapy and to report the outcomes of surgical intervention for this condition. METHODS: The records of 148 patients with epiphora associated with docetaxel therapy who were evaluated at the Ophthalmology Service at The University of Texas M. D. Anderson Cancer Center were reviewed. The frequency of docetaxel administration, the dose intensity, the cumulative dose of docetaxel, and any concomitant chemotherapeutic agents were recorded. Each patient underwent an ophthalmologic examination and in-office probing and irrigation. The patients either were treated with topical steroids or offered a surgical procedure for canalicular stenosis- (silicone intubation, dacryocystorhinostomy [DCR] with the placement of silicone tubes, or DCR with the placement of Pyrex glass tubes), depending on the severity of the canalicular stenosis. RESULTS: Docetaxel was given weekly in 71 patients, every 2 weeks in 5 patients, and every 3 weeks in 72 patients. Thirty patients (59 eyes) who received weekly docetaxel underwent surgery to correct epiphora. Twenty-three patients (39 eyes) were treated with temporary silicone tube placement, 9 patients (13 eyes) were treated with DCR with temporary silicone tube placement, and 4 patients (7 eyes) were treated with DCR with permanent Pyrex glass tube placement. Twenty-nine of the 30 patients who underwent surgery reported improvement or total resolution of epiphora after the procedure. Ten additional patients (20 eyes) who received weekly docetaxel had complete closure of their canaliculi but elected not to undergo surgery. Of special note were two patients who received weekly docetaxel in the neoadjuvant setting and developed complete closure of the canaliculi. Of the patients who received docetaxel every 2 or 3 weeks, only 3 required a surgical intervention to correct epiphora; none required Pyrex glass tube placement. CONCLUSIONS: Canalicular and nasolacrimal duct obstruction is a common side effect of weekly docetaxel therapy and can occur even when this drug is used in the neoadjuvant setting. The results of the current study indicate that early temporary silicone intubation in symptomatic patients receiving weekly docetaxel can prevent further closure of the lacrimal drainage apparatus and obviate more involved surgical interventions and permanent Pyrex glass tube placement. Cancer 2003;98:504-7.

Adult↗
PubMed1992

Canaliculocystostomy combining microsurgery and fibrin sealing of the anastomosis.

I present a method of using fibrin sealing for anastomosis in canaliculocystostomy. A microsurgical resection of the stenosis of the common canaliculus is followed by silicone intubation of the lacrimal apparatus and fibrin sealing of the anastomosis of the canaliculi and the lacrimal sac. The silicone tube is removed 6 months postoperatively. This technique obviates microscopic sutures, reduces operating time, and provides hemostasis. Of seven patients with monolateral stenosis of the common canaliculus in whom this technique was used and who were followed for a minimum of 3 years, only one had a restenosis.

Anastomosis, Surgical↗
PubMed1996

[Dacryocystography in digital subtraction technique].

The authors emphasize the usefulness of dacryography to approach patients affected by epiphora. Digital dacryocystography had improved the anatomic and functional assessment of lacrimal apparatus. The methodology allowed in all patients an accurate visualization of the lacrimal system and the identification, in twenty cases, of pathological causes of epiphora. One patient was examined after dacryocystorinostomy. Digital dacryocystography is a very valuable technique for better contrast resolution, the subtraction of images, and continuous acquisition.

Adolescent↗