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Around 6% of infants have congenital nasolacrimal duct obstruction, or dacryostenosis, usually experiencing a persistent watery eye even when not crying. If a secondary infection occurs (dacryocystitis), purulent (yellow / green) discharge may be present. Most cases resolve spontaneously, with antibiotics reserved only if conjunctivitis occurs.
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 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.
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The canal containing the duct is called the nasolacrimal canal.It is formed by indentations in the inferior nasal conchae, maxilla and lacrimal bone.The canal drains into the nasal cavity through the anterior portion of the inferior meatus, which is between the inferior concha and the floor of the nasal cavity.
Atrophic rhinitis is an absolute contraindication. In case of acute dacryocystitis, this operation can not be done immediately, rather it is done after a period of time. In case of elderly patients (above 70 years of age), dacryocystectomy is preferred to dacryocystorhinostomy as old age naturally causes atrophy in nasal mucosa.