Avoiding dacryocystorhinostomy in cases of epiphora caused by inferior meatus obstruction

作者：Koenigstein Dvir^*; Ben Cnaan Ran; Keren Shay; Leibovitch Igal; Safadi Ahmad; Land**erg Roee; Abergel Avraham

来源：Eye, 2018, 32(8): 1406-1410.

DOI：10.1038/s41433-018-0103-6

Aims To determine the role of inferior meatus pathologies as an underdiagnosed cause of epiphora.
Methods This study was conducted in the oculoplastic institution of Tel Aviv medical centera regional referral center. A retrospective review of files of patients presenting to the lacrimal clinic with nasolacrimal duct obstruction between October 2010 and September 2016. Cases in which a pathology of the inferior meatus was identified and treated are presented in this article.
Results During this time frame, we preformed 186 endoscopic dacryocystorhinostomy surgeries. Out of those, eight patients (4.3%) were diagnosed and treated for pathology causing an obstruction of the inferior meatus. Seven of our patients were females; the mean age was 24 years. A wide range of pathologies were found: cysts, dacryoliths, membranes obstructing the inferior meatus, and concheal obstruction. All patients went through endoscopic treatment targeted at the cause of obstruction. During follow-up (average 35 months) only two patients remained symptomatic and were referred for an endonasal endoscopic dacryocystorhinostomy.
Conclusions Inferior meatus obstruction is an underdiagnosed cause of epiphora. Multiple pathologies may co-exist in the same patient. In select cases of NLDO, diagnosis and treatment can be done endoscopically, avoiding the need for dacryocystorhinostomy.

• 出版日期2018-8