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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.
With the advent of nasal endoscopes, endoscopic dacryocystorhinostomy is becoming popular. In this procedure, a nasal endoscope is used to visualise the lacrimal sac through the nasal cavity. The bone covering the lacrimal sac is nibbled out. The medial wall of the sac is incised or excised, facilitating drainage of tears into the nasal cavity.
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.
Dacryoscintigraphy (DSG), also known as lacrimal scintigraphy, is a nuclear medicine technique for imaging the lacrimal apparatus. It is used to identify obstructions, for example in the lacrimal duct , nasal cavity or nasolacrimal duct .
Created Date: 8/30/2012 4:52:52 PM
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.
Causes of epiphora are any that cause either overproduction of tears or decreased drainage of tears, resulting in tearing onto the cheek. [2] This can be due to ocular irritation and inflammation (including trichiasis and entropion) or an obstructed tear outflow tract, which is divided according to its anatomical location (i.e., ectropion, punctal, canalicular or nasolacrimal duct obstruction).
A conjunctivorhinostomy is a surgical correction of the total obstruction of a lacrimal canaliculus by which the conjunctiva is anastomosed with the nasal cavity to improve tear flow. [33] A corectomedialysis, or coretomedialysis, is an excision of a small portion of the iris at its junction with the ciliary body to form an artificial pupil. [33]