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External dacryocystorhinostomy combined with mucosal grafting and magnetic resonance imaging
1Department of Ophthalmology, Kagoshima University Faculty of Medicine, Kagoshima, Japan.
Purpose:
To facilitate understanding of the use of magnetic resonance imaging (MRI) in nasolacrimal obstructive diseases and to determine the indication for external dacryocystorhinostomy (DCR) combined with mucosal grafting.
Methods:
We retrospectively studied the correlation between MRI images and surgical findings in 13 consecutive patients with swollen lacrimal sacs because of obstruction of the nasolacrimal duct or lacrimal sac. They were treated at the Kagoshima University Hospital between June 1999 and May 2001.
Results:
A simple procedure of external DCR was performed in 9 cases, and a procedure combined with mucosal grafting was performed in 4 cases (age range, 51-88 years). Surgical findings in the fibrous region of the lacrimal sac corresponded to the hyperintense signal on MRI T(1)-weighted (T1W) images, more remarkably after enhancement. Surgical findings in the granulomatous sac and proteinaceous contents corresponded to the isointense areas on T2W images. Cases with thin sac were treated by standard DCR, whereas cases with thick, fibrous and granulomatous sac were treated by external DCR combined with mucosal grafting.
Conclusions:
The MRI images provide a useful preoperative determination for indications of external DCR combined with mucosal grafting.