Intraosseous approach to the nasolacrimal duct for removal of a foreign body in a dog

Abstract

A Labrador retriever was evaluated because of chronic mucopurulent discharge from the left eye. A foreign body was identified in the nasolacrimal duct by use of dacryocystorhinography. Attempts to alleviate the inflammation by use of flushing and administration of antimicrobials were unsuccessful. At surgery, the infraorbital foramen was used as a landmark for a skin incision, because the nasolacrimal duct courses dorsal and parallel to the infraorbital canal. An air drill was used to remove the portion of the maxillary bone overlying the nasolacrimal duct, which exposed the intraosseous portion of the duct and allowed removal of a plant-material foreign body. The incision in the duct was allowed to heal by second intention, and the dog recovered without complications.

Calcification associated with the nasolacrimal system of a horse: case report and mineralogic composition

“…In this case, differential considerations for the unattached, calcific mass eroding through the lateral nasal wall and involving the nasolacrimal apparatus included internal, excessive growth of dacryolithiasis 3 ; external, metaplasia of inflammatory secretions secondary to sinusitis, 16 rhinitis, 16 or periapical tooth root abcessation 17 ; or neoplasia 18 . Foreign body 11,12,19 or previous surgery 20 resulting in calcifying, chronic inflammatory accumulations were considered unlikely. Topical instillation of epinephrine solution was not reported 15 .…”

Dacryocystomaxillorhinostomy for chronic dacryocystitis in a dog

“…Surgery was planned once contrast DCR and CT imaging studies localized the rostral dilated NL sac as the site of obstruction in this patient. Surgical approach used in this dog was modeled after a recent report, 24 which describes using the infraorbital foramen as a landmark when making the initial skin incision. The NL sac occupies a depression in the center of the orbital surface of the lacrimal bone known as the fossa sacci lacrimalis 50,51 .…”

“…Surgical approach to the lacrimal sac using a skin incision made at the level of the ventromedial orbital rim, parallel to the lower lid margin, has been reported 19,52 . A rostral to caudal skin incision, using the infraobital foramen as a landmark, enables the surgeon to gain access to the lacrimal sac and proximal NL duct without making the incision too far dorsally and inadvertently penetrating the nasal cavity directly 24 . In addition, in the event that additional rostral or caudal exposure of the NL system may have been necessary, widening the surgical field is facilitated by using a skin incision that parallels the course of the NL system 24 .…”

“…Acquired conditions may arise primarily from NL epithelium or secondary to disease extending from surrounding tissues, including nasal and oral cavities, skin, or globe 10 . Infection (dacryocystitis, 9,18,19 abscess, 20,21 granuloma, 22 inflammation (hypersensitivity reactions 1 )), foreign body, 9,23,24 cysts, 25–27 trauma, 28,29 or neoplasia 1,10 may cause NL obstruction. Infectious processes include bacterial, 20 viral, 30 fungal, 31 or parasitic 32,33 causes.…”

Bilateral nasolacrimal duct atresia in a cria

“…Dacryocystorhinography (DCRG) has been used in numerous species including camelids. 2,50,51 Other modalities used to evaluate the lacrimal outflow system include endoscopy, 41,52 ultrasound, 31 scintigraphy, 53 computed tomography (CT) 34,[54][55][56] and magnetic resonance imaging (MRI). 34 Surgical procedures used for establishing alternative outflow include canaliculorhinostomy, 35 canaliculodacryocystorhinostomy, 57 external dacryocystorhinostomy (DCR), 58 endoscopic laser DCR, 59 dacryocystomaxillorhinostomy, 54,60 CRH, 14,61-64 CMS, 14,33 and conjunctivobuccostomy.…”