Squamous papilloma of the lacrimal sac and the nasolacrimal canal (clinical case report)
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Abstract:
The article gives a detailed description of the clinical case of a rather rare eye disease - tumors of the lacrimal SAC and nasolacrimal duct, that usualy is difficult in diagnosis and treatment. We used computer tomography, dacryocystography, endoscopy for examination. The operation of removing tumor of the lacrimal SAC is well described and illustrated. Distinctive appearance of squamous papilloma, which is different from the prevailing views of papilloma attracts attention. Also we noted the number of postopertive features. The paper includes review of the literature concerning tumors of the lacrimal SAC and nasolacrimal duct, analisys of criteria for differential diagnostics of tumors of the lacrimal SAC, classification of malignant tumors of the lacrimal SAC in stages. The information obtained can contribute to the proper diagnosis and treatment of patients with pathology of the lacrimal drainage than will be useful for clinical ophthalmologists.Keywords:
Lacrimal sac
Nasolacrimal duct
Lacrimal apparatus
Lacrimal duct
The article gives a detailed description of the clinical case of a rather rare eye disease - tumors of the lacrimal SAC and nasolacrimal duct, that usualy is difficult in diagnosis and treatment. We used computer tomography, dacryocystography, endoscopy for examination. The operation of removing tumor of the lacrimal SAC is well described and illustrated. Distinctive appearance of squamous papilloma, which is different from the prevailing views of papilloma attracts attention. Also we noted the number of postopertive features. The paper includes review of the literature concerning tumors of the lacrimal SAC and nasolacrimal duct, analisys of criteria for differential diagnostics of tumors of the lacrimal SAC, classification of malignant tumors of the lacrimal SAC in stages. The information obtained can contribute to the proper diagnosis and treatment of patients with pathology of the lacrimal drainage than will be useful for clinical ophthalmologists.
Lacrimal sac
Nasolacrimal duct
Lacrimal apparatus
Lacrimal duct
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The authors successfully assessed the lacrimal systems of two patients with dacryocystocele based on dacryocystographic observations using computed tomographic scanning. The results showed that both the lacrimal sac and the nasolacrimal duct were largely distended, and the duct terminated in a closed cyst in the nasal cavity.
Nasolacrimal duct
Lacrimal duct
Lacrimal sac
Dacryocystitis
Nasolacrimal Duct Obstruction
Lacrimal apparatus
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The analysis of objective research data obtained during the examination of patients suffering from chronic dacryocystitis is presented. The importance of modern as well as traditional methods was defined. It was shown that the modern diagnostic method - lacrimal endoscopy is indicative and informative, not only with confirmed chronic dacryocystitis but also in the absence of pathological changes in the lacrimal ducts in patients of the control group. The aim of the studi was to improve the quality of diagnosis of chronic dacryocystitis. There are traditional methods for diagnosing chronic dacryocystitis. They were also used in patients of the control group (without pathology of lacrimation) and in patients with chronic dacryocystitis. Refers to them sounding of the lacrimal ways, washing them with lacriminal cannulas, slit lamp biomicroscopy, color nasal lacrimal test 2% fluorescein sodium solution for its implementation, lacrimal endoscopy with lacrimal endoscope. A total of 20 patients were examined. In the control group of patients, with the help of lacrimal endoscopy, the normal appearance of the mucous membrane of the lacrimal tubules, lacrimal sac, the nasolacrimal duct was determined. Active patency of the tear ducts was confirmed by a positive color nasal lacrimal breakdown. When performing endoscopy of the lacrimal passages in patients of the second group, the criteria for pathological changes in the lacrimal sac and nasolacrimal duct, characteristic for chronic dacryocystitis, are determined: hyperemia, the presence of detachable, grayish folds of the mucous membrane, whitish-gray membrane in the area of stricture. The preliminary diagnosis of chronic dacryocystitis was also confirmed by traditional diagnostic methods: color lacrimal-nasal functional test, diagnostic sounding. and lacrimal lavage, dacryocystography. As a result of the study, it was found that lacrimal endoscopy significantly expands the possibilities of diagnosing chronic dacryocystitis, confirms and complements the data of traditional research methods, allows you to see structural changes along the tear ducts, determines the degree and level of obliteration. The combination of traditional diagnostic methods and lacrimal endoscopy allows the surgeon to choose the most appropriate way of surgical treatment of this pathology.
Lacrimal duct
Dacryocystitis
Lacrimal sac
Nasolacrimal duct
Chronic dacryocystitis
Endoscope
Lacrimal canaliculi
Lacrimal apparatus
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Inverted papillomas (IPs) are benign, locally aggressive neoplasms with a high recurrence rate that most commonly arise from the lateral nasal wall. Rarely, IP can originate from the lacrimal sac and/or nasolacrimal duct (NLD) system. A 58-year-old man presented with chronic epiphora and an enlarging mass inferior to his left medial canthal tendon (MCT) for 2 years.The patients' clinical presentation and surgical management are described. A literature review on IP of the lacrimal sac and NLD system was conducted.Case report.We present a case of an IP that arose primarily from the lacrimal sac and grew below the MCT rather than extending above it. This is one of few published case reports detailing the use of a combined endoscopic and external approach for the resection of an IP of the lacrimal sac.Combined endoscopic and external resection is a viable approach for complete removal of extensive IP of the lacrimal sac and NLD system. IP arising from the lacrimal sac may grow below the MCT or extend above it as previously reported.
Lacrimal sac
Inverted Papilloma
Presentation (obstetrics)
Lacrimal duct
Nasolacrimal duct
Lacrimal apparatus
Case presentation
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A computed tomograph (CT) scanner was used in the diagnostics of diseases of the lacrimal drainage system. During the past three years, 22 patients with lacrimal disease were examined: 20 patients with dacryocystitis, two of them after maxillo-facial injury, and two with lacrimal sac tumor. Computed tomographic dacryocystography (CTD) was used to diagnose dacryocystitis or other types of obstruction in the lacrimal sac or nasolacrimal duct. In dacryocystitis cases CTD clearly visualized the lacrimal sac, the nasolacrimal duct and its connections with the surrounding bone tissue, and showed the correct anatomical obstruction site, even in complicated cases. In tumor cases, CT with intravenous contrast material was used to detect the extent of the tumor and also the bone defect. Because of the expense, the authors suggest ultrascan diagnostics as the first choice of imaging diagnostic method in simple dacryocystitis cases, and the use of CT and other imaging diagnostic methods in complicated cases.
Lacrimal sac
Dacryocystitis
Nasolacrimal duct
Lacrimal duct
Nasolacrimal Duct Obstruction
Lacrimal apparatus
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Background/aims
To review management choices and outcomes for congenital lacrimal (anlage duct) fistulae performed by a single ophthalmologist over a 10-year interval.Methods
All cases of congenital lacrimal fistulae with minimum follow-up of 1 year, seen and managed by the senior author (PJD) from 2000 to 2010, were retrieved from electronic medical records. Recorded data included demographic features, associated abnormalities of the lacrimal outflow apparatus and type of surgical intervention and outcome.Results
15 cases of lacrimal fistulae were identified. 67% were males, and mean age of presentation was 5 years. All presented with tearing from the eye or fistulous opening. Two patients had Down syndrome (13%). Mean follow-up was 7.3 years. While two cases required excision combined with endonasal dacryocystorhinostomy (DCR) or intubation, 9 of 11 (82%) operated cases were successfully treated with simple excision alone. Spontaneous resolution of symptoms occurred in 27% following successful treatment of concurrent nasolacrimal duct obstruction with lacrimal sac massage; in two of these cases, the fistulae were probed and found to have sealed spontaneously. The most common site of the fistula was at the inferior medial canthal area and was connected to the lacrimal sac or common canaliculus in all cases.Conclusions
Congenital lacrimal fistulae may be successfully treated with simple excision alone in most cases. Adjunctive DCR or intubation can be reserved for those identified to have lacrimal outflow tract abnormalities.Lacrimal duct
Lacrimal sac
Nasolacrimal duct
Nasolacrimal Duct Obstruction
Lacrimal apparatus
Dacryocystitis
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Nasolacrimal duct
Lacrimal sac
Chronic dacryocystitis
Dacryocystitis
Lacrimal duct
Lacrimal apparatus
Nasolacrimal Duct Obstruction
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In Brief Purpose: The purpose of this study was to describe a new surgical technique for the complete excision of the lacrimal drainage apparatus (LDA) that combines external and endoscopic approaches. Methods: This study involved a noncomparative, retrospective chart review of the clinical and pathological findings of four patients presenting with LDA papillomas who underwent a combined open and endonasal excision of the lacrimal system. Results: Of the four patients, three were male. The mean age at referral was 41 years, and all cases were unilateral. Histopathology revealed two transitional cell papillomas, one squamous cell papilloma, and one combined transitional/squamous papilloma. Epiphora and an external lesion were the main complaints at presentation. Nasolacrimal duct obstruction was present in all four patients. Papilloma virus infection was suggested in two cases and was confirmed in the only patient who had recurrence. CT identified a solid enhancing mass in two cases. The surgical approach in all cases was performed with the patient under general anesthetic supplemented with infiltration of local anesthesia with vasoconstriction. The lacrimal sac was exposed as per an external dacryocystorhinostomy with biopsy collection from the lacrimal sac lumen to confirm the diagnosis prior LDA excision. The superior aspect of the LDA was isolated by using lacrimal probes in each canaliculus to stabilized parallel incisions and careful dissection toward the common canaliculus until they met the medial aspect of the lacrimal sac. The sac was then separated from the periosteum from the medial orbital wall, using sharp dissection. Finally, an endoscopic dissection of the lower end of the nasolacrimal duct released the most inferior aspect of the LDA, allowing the surgeon to pull and excise the complete system from the external wound. Conclusions: Extensive LDA papillomas required complete excision of the drainage system to prevent recurrence and/or malignant transformation. The use of a combined approach through an open excision of the superior part of the LDA in conjunction with the direct manipulation of the nasolacrimal duct guided by the nasal endoscope facilitates the complete excision of the system for extensive benign lesions. A dual approach facilitates complete removal of extensive benign lesions.
Lacrimal sac
Lacrimal apparatus
Nasolacrimal duct
Nasolacrimal Duct Obstruction
Inverted Papilloma
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Objective To observe the CT manifestations of the normal lacrimal drainage system and lacrimal pathway obstruction.Methods CT pictures of 32 cases with normal lacrimal drainage, and 19 cases with lacrimal pathway obstruction were reviewed and analyzed.Results Of the 32 cases with normal drainage, 78.1% of the lacrimal sac could be identified, and 21.9% could not be identified. All nasolacrimal ducts could be clearly displayed with axial computer tomography. Gas may be present in normal lacrimal sacs and ducts that had been identified, or soft tissue may be present in the images. High density mass and the expansion of the lacrimal sac and nasolacrimal duct were observed in four CT pictures of neoplasia. Higher tissue density and bony pieces in the lacrimal sac area, fractures and obstruction of the nasolacrimal duct were found in 9 cases with trauma. Thickened soft tissue and higher density in the lacrimal sac area and nasolacrimal duct opacity were seen in 6 cases with dacryocystitis and sinusitis.Conclusion Axial computer tomography can display a majority of the lacrimal sacs and all nasolacrimal ducts. Normal lacrimal sacs and ducts may have air or soft tissue present in the image. Neoplasia, trauma and inflammation of the lacrimal sac and nasolacrimal duct can be clearly displayed with CT scans.
Lacrimal sac
Nasolacrimal duct
Lacrimal duct
Dacryocystitis
Lacrimal canaliculi
Nasolacrimal Duct Obstruction
Lacrimal apparatus
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