Investigating estrogen and progesterone receptors in the lacrimal sacs of individuals with and without chronic dacriocystitis

Abstract

IntroductionChronic dacryocystitis is a long-lasting, non-infectious inflammation of the lacrimal sac that leads to epiphora (1). It is more common in females than males (2), which may be due, at least in part, to the anatomically narrower nasolacrimal duct in females (3). The exact pathophysiology is not clear.Age seems an important factor, since most chronic dacryocystitis patients are middle-aged, although young individuals may also be affected. A lack of the estrogen hormone may be a cause and explain the presence of the disease in some males, (4) but this does not explain the presence of chronic dacryocystitis in premenopausal females. The presence or Objectives: Chronic dacryocystitis is usually seen in middle-aged or older women, suggesting that decreased estrogen and progesterone serum levels may be a causative factor in the disease pathology. However, the occurrence of the disease in premenopausal females and males suggests that there may be more to the explanation than the level of female sex hormones. The purpose of the present study was to investigate estrogen and progesterone receptor positivity in the lacrimal sacs of individuals with and without chronic dacryocystitis. Methods: The study group included 50 female and 20 male patients diagnosed with chronic dacryocystitis. Lacrimal sac samples were taken during a dacryocystorhinostomy. The control group comprised 29 cadavers with no evidence of lacrimal system pathology in the health records. The samples were obtained transconjunctivally. Lacrimal sac samples from both groups were stained with the estrogen and progesterone receptor protein antigen. Fisher's exact test and a chi-square test were used to compare the receptor positivity results of premenopausal and postmenopausal women, and samples of those with dacryocystitis and cadaver sacs without the disease. Results: In the control group, estrogen receptor positivity was observed in the samples of 2 premenopausal females. In the study group, estrogen receptor positivity was seen in 4 premenopausal females. There was no significant difference in estrogen receptor positivity between the premenopausal and postmenopausal female groups (p=0.41). A similar result was not established between the premenopausal and postmenopausal females in case group (p=0.056). No comparison was made of the progesterone receptor because only 1 example of progesterone receptor positivity was found in a premenopausal female in the dacryocystitis group. Conclusion: Estrogen receptor positivity did not seem to be a factor in chronic dacryocystitis physiopathology.

Analysis of the safety and effectiveness of endoscopic nasal dacryocystorhinostomy in the remedy of chronic dacryocystitis

“…Chronic dacryocystitis predominantly affects middle-aged and elderly women and its incidence is rising due to population aging and lifestyle changes. [7,25,26] While surgery remains the primary treatment, traditional EXT-DCR, despite its effectiveness in alleviating symptoms like tears and pus, has been limited by relatively large surgical incisions, higher complication rates, and recurrence. [9,12,27] In contrast, END-DCR has gained widespread clinical adoption in recent years.…”

“…The underlying reason for END-DCR's efficacy is its ability to create appropriately sized bone pores, fostering the formation of a wider nasal mucosa flap, which effectively relieves obstruction caused by stenosis of the lacrimal passage. [8,26] The use of a nasal endoscope ensures a clear surgical field and minimizes damage to adjacent tissues. Moreover, the preservation of the medial canthal ligament during END-DCR protects the physiological structure of the lacrimal sac, aiding postoperative recovery.…”

A case report of chronic dacryocystitis caused by nasal stones

“…Chronic dacryocystitis is more common in middle-aged and elderly women, and clinical case reports of dacryocystitis in male patients are rare (28.7%, 23.1%, and 32.4%, respectively) [ 10 – 12 ]; additionally, only 1.35% of male patients with dacryocystitis are over 60 years old [ 12 ], which may be due to the narrowness of the nasolacrimal duct in the female anatomy [ 13 ]. Nasolacrimal duct obstruction is the most important cause of dacryocystitis [ 14 ].…”