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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.
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.
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).
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.
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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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