Co-Occurrence and Possible Role of Sinonasal Anomalies in Primary Acquired Nasolacrimal Duct Obstruction

Abstract

Our objective was to determine the co-occurrence of sinonasal anomalies and primary acquired nasolacrimal duct obstruction. A total of 41 patients were enrolled in the study, of which 41 had primary unilateral acquired nasolacrimal duct (NLD) obstruction. All patients included in the study were evaluated by anterior rhinoscopy, endoscopic nasal examination, and paranasal sinus computed tomography (CT) in order to reveal significant nasal and paranasal pathology. A significant increase was noted in the rate of concha bullosa, inferior turbinate hypertrophy, osteomeatal complex disease, and maxillary sinusitis in favor of the study group (P < 0.05). Nasal septal deviation, irregularity of middle turbinate, paradoxical middle turbinate, ethmoidal sinusitis, and Onodi cell and agger nasi cell incidence were found to be high in the study group. However, none of this increase was statistically significant (P > 0.05). Although primary acquired NLD obstruction seems to be an ophthalmologic problem, rhinologic problems have great importance in etiology. Detailed endoscopic examination and preoperative paranasal sinus computed tomography will reveal the possible role of nasal and paranasal structures adjacent to lacrimal sac in etiology of NLD obstruction. This will be effective both on conservative treatment and postoperative success in patients scheduled for surgery.