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A dacryocystorhinostomy is the treatment of choice for most patients with acquired nasolacrimal duct obstruction. Surgical indications include recurrent dacryocystitis, chronic mucoid reflux, painful distension of the lacrimal sac, and bothersome epiphora.
The lacrimal punctum (pl.: puncta) or lacrimal point is a minute opening on the summits of the lacrimal papillae, seen on the margins of the eyelids at the lateral extremity of the lacrimal lake. There are two lacrimal puncta in the medial (inside) portion of each eyelid. Normally, the puncta dip into the lacrimal lake.
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.
Tears are produced by the lacrimal gland, situated just outside the eye. Blinking the eyelids distributes the tears to keep the eyes moist, clean and lubricated. Excess tears are drained via the punctum through the tiny channels called canaliculi located on the inner side of the eyes into the tear sac, from there to the tear duct, the nose and finally down the throat.
Canaliculotomy involves slitting of the lacrimal punctum and canaliculus for the relief of epiphora [33] A dacryoadenectomy is the surgical removal of a lacrimal gland. [33] A dacryocystectomy is the surgical removal of a part of the lacrimal sac. [33] A dacryocystostomy is an incision into the lacrimal sac, usually to promote drainage. [33]
A punctal plug, also known as tear duct plug or lacrimal plug, is a small medical device that is inserted into the tear duct (puncta) of an eye to block the duct. This prevents the drainage of liquid from the eye. They are used to treat dry eye. Artificial tears are usually still required after punctal plug insertion. [1]
Punctal irrigation is also required. In infants with nasolacrimal defects, a nasolacrimal duct probe is used and a tube replacement, either temporary (Crawford) or permanent (Jones), is carried out. A surgical procedure called a dacryocystorhinostomy is done to join the lacrimal sac to the nasal mucosa in order to restore lacrimal drainage.
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.