Successful Treatment of Nasolacrimal Duct Obstruction Secondary to Fibrous Dysplasia by External Dacryocystorhinostomy With Mitomycin C

Abstract

A 60-year-old woman developed polyostotic fibrous dysplasia involving the right zygomatic and maxillary bones, which led to swelling along the right side of her nose that was associated with constant epiphora. A sac washout revealed a blocked right nasolacrimal duct, which was confirmed by CT dacryocystography. CT also showed signs of fibrous dysplasia in the maxillary and zygomatic bones in the form of bony expansion and ground-glass bone density. The patient underwent external dacryocystorhinostomy with mitomycin C and O'Donoghue tube insertion. Bone punched out while fashioning the bony nasal ostium was subjected to histopathologic examination, which confirmed the diagnosis of fibrous dysplasia. The O'Donoghue tubes were removed 8 weeks later. At 15 months postoperatively, the dacryocystorhinostomy was patent and the patient was completely relieved of her symptoms.