Complete Nasolacrimal Duct Obstruction Research Articles

Lacrimal duct recanalization with balloon catheter

In dilation of nasolacrimal duct stenosis materials now being used originally were developed for percutaneous transluminal coronary angioplasty (PTCA). Suitable modifications of the angioplasty equipment could improve therapeutic results and thus influence the area of indication of this new technique. In addition to the standard PTCA equipment, we used a cannula designed to fit the guide wire, leading to less traumatic intubation of the lacrimal duct and allowing radiographic control of the recanalization procedure. Five patients showing relative stenosis and ten patients showing complete obstruction of the nasolacrimal duct were treated by dacryocystoplasty. Clinical and radiographic follow-up was done over a period of 6 months. In a total of seven patients, dilation proved successful. Out of these, four showed stenosis (80% recanalization rate) and three complete obstruction (30% recanalization rate) before dilation. Recanalization by dilation using balloon catheters seems to be possible even in cases of complete nasolacrimal duct obstruction. However, the success rate is considerably lower than in relative stenosis.

Clinicopathologic study of lacrimal sac and nasal mucosa in 44 patients with complete acquired nasolacrimal duct obstruction.

We studied 44 patients who had dacryocystorhinostomy for primary acquired complete nasolacrimal duct obstruction. The lacrimal sac and nasal mucosa adjacent to the osteotomy were examined histologically. The lacrimal sac had chronic inflammatory changes in 33 of 37 patients with varying degrees of fibrosis in 34 of 37. Focal ulceration of the lacrimal sac epithelium was present in 15 cases. Goblet cells, present in 11 specimens, were not identified in 26 specimens. Moderate or severe chronic inflammation was found in 14 of 44 nasal mucosal specimens and marked fibrosis in 22. The pathology of the lacrimal sac and nasal mucosa is similar to that of the nasolacrimal duct in complete nasolacrimal duct obstruction. The nasal inflammation may have resulted from dacryocystitis or alternatively contributed to the dacryocystitis.