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Nasolacrimal injuries. Evaluation and management
1Department of Otolaryngology and Communicative Sciences, Medical University of South Carolina, Charleston.
Otolaryngologic Clinics of North America
|February 1, 1991
Summary
Nasoethmoidal and midfacial fractures disrupt the tear drainage system in up to 21% of cases. Evaluation involves dye tests or dacryography, with dacryocystorhinostomy for distal obstructions.
Area of Science:
- Ophthalmology
- Maxillofacial Surgery
- Anatomy
Background:
- The nasolacrimal drainage system is integral to ocular health.
- Facial trauma, particularly nasoethmoidal fractures, can compromise tear drainage.
- Disruption leads to epiphora and potential dacryocystitis.
Purpose of the Study:
- To highlight the incidence of tear drainage system disruption in midfacial fractures.
- To outline diagnostic methods for post-traumatic epiphora.
- To specify treatment for nasolacrimal duct obstruction.
Main Methods:
- Review of literature concerning facial fractures and nasolacrimal system injuries.
- Description of diagnostic tools: Jones dye tests, probing, and dacryography.
- Explanation of surgical interventions for nasolacrimal duct obstruction.
Main Results:
- Tear drainage system compromise occurs in 17%–21% of nasoethmoidal fractures.
- Other midfacial fractures present a lesser degree of disruption.
- Epiphora and dacryocystitis are key indicators of obstruction.
Conclusions:
- Facial trauma significantly impacts the tear drainage pathway.
- Prompt and accurate diagnosis is crucial for managing complications.
- Dacryocystorhinostomy is the established treatment for distal common canaliculus obstructions.