Primary Acquired Nasolacrimal Duct Obstruction

Dacryocystostenting: technical and long-term results

“…Tuttavia si tratta di una chirurgia aggressiva, eseguita in anestesia generale e gravata da problematiche successive (riostruzioni prodotte da tessuto di granulazione, ipertrofia mucosa reattiva, formazione di fistole, emorragie intraoperatorie, cicatrici facciali) [7,8]. Per tali motivi si è cercato di ripristinare la pervietà del dotto naso lacrimale con tecniche meno invasive che rispettassero anatomia e fisiologia delle vie lacrimali: intubazioni mono o bicanalicolari con sonda di Hat e sue varianti, dacrioprotesi per via esterna, dilatazione endoluminale con microcateteri a palloncino [9][10][11][12][13][14][15][16]. L'impianto di stent in poliuretano nella via lacrimale per via endonasale, recentemente introdotto, segue le precedenti esperienze di posizionamento di stent plastici e metallici, risolvendo parte dei problemi associati alle restenosi precoci di quest'ultimi, agli inestetismi facciali delle ferite chirurgiche e alla morbilità post operatoria [17][18][19].…”

“…It is, however, an aggressive procedure that is performed under general anaesthesia and that carries a risk of complications (re-obstruction produced by granulation tissue, reactive mucosa hypertrophy, fistulas, intraoperative bleeding, facial scars) [7,8]. For these reasons, attempts have been made to restore the patency of the nasolacrimal duct by using less invasive techniques that respect the anatomy and physiology of the lacrimal system: uni-or bicanalicular intubation with a Hat probe and its variants, external dacryostenting and luminal dilatation with balloon microcatheters [9][10][11][12][13][14][15][16]. Endonasal positioning of a polyurethane stent in the lacrimal duct is a recent technique that developed out of previous experiences with plastic and metallic stents, solving part of the problems associated with early restenosis, facial scarring due to surgical incision and post-operative morbidity [17][18][19].…”

Upregulation of inflammatory genes in the nasal mucosa of patients undergoing endonasal dacryocystorhinostomy

“…The common cause of epiphora and discharge from the eye in adults is nasolacrimal duct obstruction (NLDO). The pathogenesis of NLDO is unknown, but the process is characterized by gradual inflammation and subsequent fibrosis of the nasolacrimal duct, which may lead to obstruction of the lacrimal pathway 1,2. Endoscopic dacryocystorhinostomy (EN-DCR) is an effective and safe surgical technique for treating symptomatic lower lacrimal pathway obstruction and dacryocystitis in cases where there is no response to conservative treatment.…”

Lacrimal duct obstruction after radioiodine therapy: case report and treatment

“…Obstrução da via lacrimal após radioiodoterapia: relato de caso e conduta INTRODUCTION N asolacrimal duct obstruction in adults (1)(2)(3) can be classified as primary (which involves a lymphocytic infiltrate culminating in a scarring process) and secondary (due to various situations such as therapeutic irradiation of nasopharyngeal carcinoma and basal cell carcinoma of the inner canthus, radioiodine therapy for thyroid carcinoma, midfacial fractures, leukaemia, sarcoidosis, tuberculosis, trachoma, Down syndrome, Stevens-Johnson syndrome, leishmaniasis, Hansen's disease, lymphoma, plug migration, and iatrogenic).…”

“…(1)(2)(3) Chronic dacryocystitis represents 2-3% of cases of nasolacrimal duct obstruction. (1)(2)(3) According to the literature, the most frequent causes of nasolacrimal duct obstruction are: idiopathic (59.2%), congenital (29.6%), iatrogenic (4.5%), and secondary to radiotherapy (3.7%). (4) Obstruction after radioiodine therapy is due to the presence of sodium-iodide transporters in the mucosa of the lacrimal sac and the nasolacrimal duct, which are areas of anatomic obstruction.…”