Avoiding dacryocystorhinostomy in cases of epiphora caused by inferior meatus obstruction

Koenigstein, Dvir; Cnaan, Ran Ben; Keren, Shay; Leibovitch, Igal; Safadi, Ahmad; Landsberg, Roee; Abergel, Avraham

doi:10.1038/s41433-018-0103-6

Eye

2018

DOI: 10.1038/s41433-018-0103-6

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Avoiding dacryocystorhinostomy in cases of epiphora caused by inferior meatus obstruction

Dvir Koenigstein

Ran Ben Cnaan

Shay Keren

et al.

Abstract: 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.

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2019

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Cited by 2 publications

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Clinical utility of SPECT/CT and CT-dacryocystography-enhanced dacryoscintigraphy in the imaging of lacrimal drainage system obstruction

Barna¹,

Garai²,

Kukuts³

et al. 2019

Ann Nucl Med

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PurposeEpiphora is commonly caused by a relative or complete occlusion in the lacrimal drainage system (LDS), principally a nasolacrimal duct obstruction (NLDO). Dacryoscintigraphy (DSG), an extensively assessed imaging technique in diagnosing its abnormalities, can provide only planar images, according to which it needs to be improved. Our aim was to evaluate clinical utility of simultaneous DSG and single-photon emission computed tomography/computed tomography (SPECT/CT) combined with computed tomographic dacryocystography (CT-DCG) in the evaluation of LDS.MethodsDynamic imaging with DSG was performed, and tracer radioactivity was detected by a gamma camera. Successively, SPECT/CT images of the involved region were gained, followed by CT-DCG, during which a contrast medium was syringed into the affected LDS, and finally contrast CT scans were obtained again from the same region.ResultsFifty-seven patients, mean age 54.25 (± 18.26) years all with unilateral NLDO and 32 control subjects, all with patent LDS, mean age 49.88 (± 18.61) years were evaluated in the study. Delayed outflow of tearing eyes was exposed to DSG compared to the fellow and control eyes. The highest value for sensitivity was observed for SPECT/CT, followed by CT-DCG and DSG techniques, while combining DSG with SPECT/CT, DSG with CT-DCG, and SPECT/CT with CT-DCG, the sensitivity increased to 96.49%, 92.98%, and 94.73%, respectively.ConclusionsAlthough DSG is a sensitive nuclear medicine method, it only provides useful clinical data when simultaneously supplemented with SPECT/CT and CT-DCG trials as they jointly can offer valuable information about the localization of an abnormality and verify stenosis or obstruction.

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Clinical utility of SPECT/CT and CT-dacryocystography-enhanced dacryoscintigraphy in the imaging of lacrimal drainage system obstruction

Barna¹,

Garai²,

Kukuts³

et al. 2019

Ann Nucl Med

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Meatoplasty - an effective method for surgical treatment of patients with nasolacrimal duct ostium stenosis

Atkova

Krakhovetskiy

Yartsev

et al. 2019

Vestn. otorinolaringol.

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Avoiding dacryocystorhinostomy in cases of epiphora caused by inferior meatus obstruction

Abstract: 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.

Cited by 2 publications

References 19 publications

Clinical utility of SPECT/CT and CT-dacryocystography-enhanced dacryoscintigraphy in the imaging of lacrimal drainage system obstruction

Clinical utility of SPECT/CT and CT-dacryocystography-enhanced dacryoscintigraphy in the imaging of lacrimal drainage system obstruction

Meatoplasty - an effective method for surgical treatment of patients with nasolacrimal duct ostium stenosis

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