1/48. mucocele in an orbitoethmoidal (Haller's) cell (accidentally combined with acute contralateral dacryocystitis).Haller's cells--according to recent terminology now called orbitoethmoidal cells (OEC)--are defined as anterior or posterior ethmoidal cells that have developed into the orbital floor. They can be excessively pneumatized and thus contribute to obstruction of the ostiomeatal complex area. We present the case of a 42 year old white male, who was admitted for treatment of an acute dacryocystitis on the right side. The CT scan revealed moderate sinusitis of the right ethmoid and maxillary sinuses and coincidentally a mucocele in an OEC on the left side. An endoscopic dacryocystorhinostomy on the right and a revision of the mucocele on the left side were performed in the same sitting. We consider both indications--stenosis of the nasolacrimal duct as well as mucoceles rewarding indications for endoscopic surgery. An external approach to the nasolacrimal duct in this case would have been problematic, as the external skin and soft tissue covering the duct already showed severe inflammatory changes. The operation of the up until that time asymptomatic mucocele was of prophylactic character. To our knowledge this is the first report of a mucocele developing in an OEC in the literature.- - - - - - - - - - ranking = 1keywords = obstruction, duct (Clic here for more details about this article) |
2/48. nasolacrimal duct obstruction secondary to ectopic teeth.OBJECTIVE: To describe two patients with nasolacrimal duct obstruction (NLDO) caused by ectopic eruption of teeth. The literature concerning nasal and other unusual ectopic sites of tooth eruption is reviewed. DESIGN: Two interventional case reports and literature review. PARTICIPANTS: A 3-year-old girl with epiphora and recurrent dacryocystitis of the right eye. Previous medical and surgical management was unsuccessful. A 32-year-old female with a long history of right eye discomfort and epiphora. Previous examinations and workup were negative. INTERVENTION: A computed tomographic (CT) scan of the orbits and sinuses was performed in both patients. The ectopic teeth were surgically removed. MAIN OUTCOME MEASURES: Nasolacrimal system function and response to treatment at the last follow-up were recorded. RESULTS: In the first patient, CT imaging disclosed two teeth within the right inferior meatus compressing the nasolacrimal duct. In the second patient, CT revealed a large dental structure in the maxillary sinus compressing the nasolacrimal duct. Endoscopic tooth extraction and nasolacrimal duct probing in the first patient and surgical removal of the dental structure in the second patient effected complete resolution of symptoms. Both patients were symptom free at last follow-up. CONCLUSIONS: These cases suggest that ectopic eruption of teeth should be added to the differential diagnosis of NLDO. Surgical removal of the ectopic teeth compressing the nasolacrimal duct results in resolution of the lacrimal drainage obstruction.- - - - - - - - - - ranking = 607.16903315771keywords = duct obstruction, obstruction, duct (Clic here for more details about this article) |
3/48. nasolacrimal duct foreign body--endoscopic removal.Foreign body in the nasolacrimal duct is extremely rare. We present a case of foreign body of nasolacrimal duct responsible for recurrent dacryocystitis which was removed with the help of an endoscope.- - - - - - - - - - ranking = 1.3319078377106keywords = duct (Clic here for more details about this article) |
4/48. nasolacrimal duct obstruction and dacryocystocele associated with a concha bullosa mucocele.PURPOSE: To describe the rare occurrence of a concha bullosa mucocele producing secondary nasolacrimal duct obstruction and dacryocystocele. DESIGN: Case report. PARTICIPANT: Forty-two-year-old man with 6-month history of left medial canthal mass. INTERVENTION: Clinical evaluation with lacrimal testing, computed tomography and surgical exploration, including biopsy, dacryocystorhinostomy, and excision/marsupialization of the middle turbinate concha bullosa mucocele were performed. RESULTS: The medial canthal mass was confirmed to be a dacryocystocele associated with nasolacrimal duct obstruction and bone destruction caused by concha bullosa mucocele. CONCLUSIONS: Concha bullosa mucoceles are uncommon and even more rarely can produce secondary nasolacrimal duct obstruction and dacryocystocele formation. The clinical and radiologic features may mimic a lacrimal sac malignancy.- - - - - - - - - - ranking = 848.32586792533keywords = duct obstruction, obstruction, duct (Clic here for more details about this article) |
5/48. dacryocystorhinostomy for dacryocystitis caused by methicillin- resistant Staphylococcus aureus: report of four cases.BACKGROUND: To evaluate the outcome of dacryocystorhinostomy (DCR) for dacryocystitis caused by methicillin-resistant staphylococcus aureus (MRSA). CASES: Four otherwise healthy patients with dacryocystitis caused by MRSA were studied (3 with chronic dacryocystitis; 1, acute dacryocystitis). Ophthalmic symptoms were epiphora with purulent discharge in 2 cases, with blepharoconjunctivitis in 1 case, and with lacrimal fistula in 1 case. culture of the purulent discharge from the affected conjunctival sacs revealed MRSA infection. Initial treatment, which was unsuccessful, included intravenously administered common antibiotics, the use of topical antibiotics and povidone-iodine in the conjunctival sac and mupirocin ointment in the nasal cavity. Subsequently, standard DCR was performed with a bicanalicular silicone tube inserted under local anesthesia, accompanied by the administration of common antibiotics. observation: Cultures from all patients were negative for MRSA as soon as 4 days after DCR. None of the patients had epiphora with pus, and the lacrimal passage became patent postoperatively. CONCLUSION: dacryocystitis due to MRSA was resistant to conservative therapy. DCR subsequent to the conservative therapy resulted in almost immediate resolution of the lacrimal fistula and nasolacrimal obstruction, rapid control of dacryocystitis, and a decrease in the period of MRSA infection in the conjunctiva and the nasal cavity.- - - - - - - - - - ranking = 0.33404608114469keywords = obstruction (Clic here for more details about this article) |
6/48. Stenosis of the lachrymal system in rubinstein-taybi syndrome.In this article the authors describe a case of atypical stenosis of the lachrymal excretory system in rubinstein-taybi syndrome (RTS) characterised by morphologic anomalies of the lachrymal bag and by alterations of the osseous structure of the nose. A 9-year-old girl, with typical findings of RTS, was affected by recurrent acute dacryocystitis and tearing. Ocular examination revealed bilateral reflux with mucous and purulent material flowing back after digital pressing: low and bilateral nose-lachrymal duct obstruction was the main cause of the reflux as confirmed by orifice probing, lachrymal drainage system irrigation and spiral CT examination using hydrosoluble contrast medium. The multiplanar reconstruction obtained from CT scanning shows that the right lachrymal sac has an abnormal shape ('grape-bunch' image) and that the left one has various bulgings, or swellings, in its shape. The 'grape-bunch' lachrymal bags are the most unusual features of our patient's lachrymal system and it is important to consider the difficulties that could occur during surgery because of the abnormal bag shape and because of the increased bone thickness in RTS patients. The 'grape-bunch' lachrymal sac is a truly unusual anatomical feature and, most probably, it could be distinctive of this syndrome.- - - - - - - - - - ranking = 121.18940970362keywords = duct obstruction, obstruction, duct (Clic here for more details about this article) |
7/48. A case of acute dacryoadenitis associated with herpes zoster ophthalmicus.BACKGROUND: Acute dacryoadenitis is an uncommon disease. CASE: We present what we believe to be the first reported case of herpes zoster ophthalmicus with the onset of acute dacryoadenitis. OBSERVATIONS: A 30-year-old man complained of severe ocular pain and hyperemia in his right eye. magnetic resonance imaging (MRI) demonstrated enlargement of the right lacrimal gland and acute dacryoadenitis was diagnosed. Two days after treatment with systemic antibiotics he developed iridocyclitis and skin lesions confined to the first division of the trigeminal nerve; therefore, herpes zoster ophthalmicus was diagnosed. Treatment with acyclovir immediately resolved the ocular pain and swelling of the upper eyelid. MRI conducted in the 4 months after the initial examination showed there was no longer enlargement of the right lacrimal gland. CONCLUSION: Clinicians should be aware that varicella-zoster virus may cause acute dacryoadenitis.- - - - - - - - - - ranking = 0.22198463961844keywords = duct (Clic here for more details about this article) |
8/48. Squamous cell carcinoma of the lacrimal sac.The clinical and histopathological findings in a 40-year-old man with a lacrimal sac tumor are reported. Although the clinical history indicated a lacrimal sac obstruction and recurrent dacryocystitis, the lesion was diagnosed by light microscopy as a squamous cell carcinoma.- - - - - - - - - - ranking = 0.33404608114469keywords = obstruction (Clic here for more details about this article) |
9/48. Atypical presentation of fungal dacryocystitis. A report of two cases.BACKGROUND: candida albicans has only rarely been implicated in nasolacrimal duct obstruction. Its association with dacryoliths is well known, but it is unclear whether it is an etiologic factor or is present as a result of the obstruction. FINDINGS: The authors report 2 cases of fungal dacryocystitis that were not associated with dacryolith formation and where Candida species appear to be the primary etiologic agent. CONCLUSION: The possibility of a fungal infection should be considered in the evaluation of "routine" chronic dacryocystitis, particularly in the presence of corneal ulceration or postoperative endophthalmitis, as prompt initiation of appropriate therapy may be crucial.- - - - - - - - - - ranking = 121.52345578476keywords = duct obstruction, obstruction, duct (Clic here for more details about this article) |
10/48. Bilateral dacryocystitis after punctal occlusion with thermal cautery.A 61-year-old woman developed acute bilateral dacryocystitis secondary to Staphylococcus aureus 3 weeks after undergoing punctal occlusion with thermal cautery for keratoconjunctivitis sicca. The dacryocystitis resolved with intravenous antibiotics, aspiration of the lacrimal sacs, injection of sulfacetamide into the lacrimal sacs, and bilateral dacryocystorhinostomy. Preexisting bilateral nasolacrimal duct obstruction was postulated as the underlying cause. In these cases, irrigation of the lacrimal system is recommended before proceeding with punctal occlusion.- - - - - - - - - - ranking = 121.18940970362keywords = duct obstruction, obstruction, duct (Clic here for more details about this article) |
| | Next -> |