Osteoma of the medial wall of the maxillary sinus: a primary cause of nasolacrimal duct obstruction and review of the literature.

Athanasios Saratziotis,Enzo Emanuelli

doi:10.1155/2014/348459

Abstract

A 74-year-old male patient presented to the outpatient department with left-sided epiphora and chronic dacryocystitis, without any history of head trauma or previous nasal or paranasal sinuses surgery. No abnormalities were noted at the time with the use of nasal endoscopy. The computed tomography scan however revealed an osteoma of the medial wall of the left maxillary sinus. An endonasal endoscopic dacryocystorhinostomy (DCR) with osteoma removal by using a drill with temporary silicone stenting of the nasolacrimal duct system was performed. Due to a granuloma formation at the DCR-window site 2 months postoperatively a revision-DCR was performed and the new window remained patent at control 6 months after surgery.

Highlights

Acquired nasolacrimal duct obstruction (NLDO) may be due to various causes including idiopathic stenosis of the nasolacrimal duct, with or without formation of nasolacrimal duct mucoceles, trauma, or surgery to the paranasal sinuses and tumors of the nasal cavity.Osteomas are benign tumors developing in the paranasal sinuses and the nasal cavity
To our knowledge, acquired NLDO associated with an osteoma of the medial wall of the maxillary sinus has not been reported in medical literature so far
A 74-year-old male patient presented to the outpatient department with left-sided epiphora and chronic dacryocystitis, without any record of head trauma or previous surgery of the nose or paranasal sinuses

Summary

Introduction

Acquired nasolacrimal duct obstruction (NLDO) may be due to various causes including idiopathic stenosis of the nasolacrimal duct, with or without formation of nasolacrimal duct mucoceles, trauma, or surgery to the paranasal sinuses and tumors of the nasal cavity. Osteomas are benign tumors developing in the paranasal sinuses and the nasal cavity They usually grow in the frontal sinus near the nasofrontal duct and, in decreasing order of frequency, in the ethmoid, sphenoid, and maxillary sinus. They usually remain asymptomatic and they tend to be an incidental finding on radiographic studies. To our knowledge, acquired NLDO associated with an osteoma of the medial wall of the maxillary sinus has not been reported in medical literature so far Various methods such as laser beams, forceps, curettes, neurosurgical microrongeurs, and drills have been used for the formation of the lateral nasal wall osteotomy during endonasal dacryocystorhinostomy (DCR) [1]. NLDO and the concomitant endonasal pathology can be simultaneously addressed

Case Presentation

Findings

Discussion