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Related Experiment Videos

[Dacryolithiasis: diagnosis using nasal endoscopy].

J-M Piaton1, P Keller, J-A Sahel

  • 1Service d'Ophtalmologie, CHNO des XV-XX, 75012 Paris. jmpiaton@aol.com

Journal Francais D'Ophtalmologie
|September 18, 2003
PubMed
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Dacryolithiasis is often missed, but nasal endoscopy can reveal Hasner valve (HV) abnormalities and mucopurulent discharge, aiding diagnosis. These findings suggest HV malformations may cause dacryolithiasis.

Area of Science:

  • Ophthalmology
  • Otorhinolaryngology
  • Medical Imaging

Background:

  • Dacryolithiasis, the formation of stones in the lacrimal sac, is frequently misdiagnosed.
  • The role of the Hasner valve (HV) in dacryolithiasis etiology is not fully understood.

Purpose of the Study:

  • To evaluate the diagnostic value of anatomical abnormalities and mucopurulent discharge at the Hasner valve (HV) for dacryolithiasis.
  • To compare these findings with other clinical and radiological signs of dacryolithiasis.
  • To investigate the potential causal link between HV abnormalities and dacryolithiasis formation.

Main Methods:

  • Prospective study of 797 epiphora surgeries, including endonasal dacryocystorhinostomies and HV meatotomies.
  • Systematic preoperative nasal videoendoscopy was performed on all patients.

Related Experiment Videos

  • Preoperative dacryocystography (DCG) and lacrimal computed tomography (LCT) were utilized.
  • Main Results:

    • Dacryoliths were identified in 6.9% of patients (55/797).
    • Mucopurulent discharge at the HV was significantly more common in patients with dacryolithiasis (45.8% vs. 5.8%, p<10(-6)).
    • Anatomical abnormalities of the HV were found in 83.3% of dacryolithiasis patients versus 11.4% in controls (p<10(-6)), including narrowing of the lacrimal pathway.

    Conclusions:

    • Nasal videoendoscopy is crucial for diagnosing suspected dacryolithiasis, identifying HV abnormalities and mucopurulent discharge.
    • The presence of mucopurulent discharge with a patent lacrimal system is highly specific for dacryolithiasis.
    • Congenital malformations of the HV are implicated as a potential cause for many dacryolithiasis cases.