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Involutional stenosis is probably the most common cause of nasolacrimal duct obstruction in older people. It affects women twice as frequently as men. Although the inciting event in this process is unknown, clinicopathologic study suggests that compression of the lumen of the nasolacrimal duct is caused by inflammatory infiltrates and edema.
Obstruction of the nasolacrimal duct may occur. [4] [5] [6] This leads to the excess overflow of tears called epiphora (chronic low-grade nasolacrimal duct occlusion). [7]A congenital obstruction can cause cystic expansion of the duct and is called a dacryocystocele or Timo cyst.
Dacryocystitis is an infection of the lacrimal sac, secondary to obstruction of the nasolacrimal duct at the junction of the lacrimal sac. [1] The term derives from Greek dákryon 'tear' cysta 'sac' and -itis 'inflammation'. [2] It causes pain, redness, and swelling over the inner aspect of the lower eyelid and epiphora.
The symptoms are occipital headache, cough, middle ear effusion, cervical myalgia, and halitosis, i.e. bad breath. When there is an enlargement of the cyst, it causes symptoms like nasal obstruction, post-nasal discharge with foul-smelling odour, blockage of the Eustachian tube causing otalgia and secretory otitis media, retro-orbital pain.
The lacrimal sac or lachrymal sac [1] is the upper dilated end of the nasolacrimal duct, [2] and is lodged in a deep groove formed by the lacrimal bone and frontal process of the maxilla. It connects the lacrimal canaliculi , which drain tears from the eye's surface, and the nasolacrimal duct , which conveys this fluid into the nasal cavity. [ 3 ]
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Nasal obstruction characterized by insufficient airflow through the nose can be a subjective sensation or the result of objective pathology. [10] It is difficult to quantify by subjective complaints or clinical examinations alone, hence both clinicians and researchers depend both on concurrent subjective assessment and on objective measurement of the nasal airway.