Abstract
Several conditions can cause acquired nasolacrimal duct (NLD) obstruction. These conditions include involutional stenosis of the NLD that presumably results from unidentified infection or autoimmune disease, dacryolith, sinus disease, naso-orbital fractures following trauma, inflammatory diseases, such as Wegener’s granulomatosis, neoplasm or iatrogenic injuries during endoscopic paranasal sinus surgery. The two jaw surgery (TJS) (i.e., maxillary and mandibular osteotomies) has recently become popular for cosmetic purposes and has become an increasing cause of concern regarding NLD obstruction. However, there have been no previously reported cases of NLD obstruction associated with TJS. The NLD can be damaged by excessively high maxillary osteotomies during TJSs, which can result in epiphora. Furthermore, in the absence of direct damage to the NLD or excessive mobilization of the maxillary bone during TJS, the soft tissues surrounding the Hasner’s valve can cause NLD obstruction. Recently, the authors experienced two cases of NLD obstruction following TJS and report those cases here.
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