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Bony nasolacrimal duct dehiscence in functional endoscopic sinus surgery: radiological study and discussion of surgical implications

Published online by Cambridge University Press:  08 April 2015

M J Ali ,
J Murphy ,
P J Wormald  and
A J Psaltis
M J Ali
Affiliation:
Dacryology Service, L V Prasad Eye Institute, Hyderabad, India
J Murphy
Affiliation:
Department of Otolaryngology – Head Neck Surgery, University of Adelaide, South Australia, Australia
P J Wormald
Affiliation:
Department of Otolaryngology – Head Neck Surgery, University of Adelaide, South Australia, Australia
A J Psaltis*
Affiliation:
Department of Otolaryngology – Head Neck Surgery, University of Adelaide, South Australia, Australia
*
Address for correspondence: Dr Alkis James Psaltis, Department of Otolaryngology – Head Neck Surgery, University of Adelaide, Adelaide, South Australia, Australia E-mail: alkispsaltis@gmail.com
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Abstract

Objectives:

To analyse the radiological features of the bony nasolacrimal duct before and after functional endoscopic sinus surgery, and document the incidence of surgically induced dehiscence.

Methods:

A retrospective case series analysis was conducted of 63 consecutive patients who underwent uncinectomy as a part of 118 functional endoscopic sinus surgical procedures. All patients underwent pre- and post-operative computed tomography scans. Axial computed tomography images at the level of maxillary sinus were evaluated for the presence of bony nasolacrimal duct dehiscence, osteitis and completeness of uncinectomy.

Results:

The rate of nasolacrimal duct dehiscence prior to surgery was 6.8 per cent (8 out of 118 cases). Nasolacrimal duct dehiscence as a consequence of surgery was observed in 3.3 per cent of cases (4 out of 118), with a further 4.2 per cent (5 out of 118) showing post-operative reactive bony change of the nasolacrimal duct in the absence of dehiscence.

Conclusion:

The incidence of nasolacrimal duct injury observed was much lower than that previously reported in the literature.

Keywords

Nasolacrimal DuctSinus SurgeryFESSComplicationsDehiscence, Surgical WoundCT Scan, X-RayLund-Mackay Scores
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 129 , Supplement S3 , July 2015 , pp. S35 - S40
Copyright
Copyright © JLO (1984) Limited 2015 

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