Related Experiment Video
Updated: Dec 14, 2025

Endoscopic Endonasal Trans-sphenoidal Approach: Minimally Invasive Surgery for Pituitary Adenomas
Published on: January 17, 2018
Epiphora and unrecognized paranasal sinuses pathology
Filippo Confalonieri1, Laura Balia1, Raffaele Piscopo1
1Humanitas Research Hospital, Rozzano, Milan, Italy.
Purpose:
to report five patients all presenting with persistent unilateral epiphora as a sign of unexpected and rare lesions causing Secondary Acquired Nasolacrimal Duct Obstruction (SANDO) and the risks associated to an incomplete diagnostic work-up.
Observations:
the cases presented are: (1) Fungus ball, (2) Pyogenic granuloma, (3) Sinonasal inverted papilloma (4) Sinonasal inverted papilloma with synchronous squamous cell carcinoma, (5) Squamous cell carcinoma of the lacrimal sac.
Conclusions And Importance:
masses are uncommon but not a rare cause of nasolacrimal duct obstruction. Surgical teams performing large numbers of dacryocystorhinostomies should be aware of such pathology and perform a systematic multidisciplinary approach.
Insights
Persistent tearing can signal rare nasolacrimal duct obstruction caused by masses. Early diagnosis and a multidisciplinary approach are crucial for effective treatment of Secondary Acquired Nasolacrimal Duct Obstruction (SANDO).
Area of Science:
- Ophthalmology
- Otorhinolaryngology
- Pathology
Background:
- Persistent unilateral epiphora is a common symptom.
- Secondary Acquired Nasolacrimal Duct Obstruction (SANDO) can arise from various causes.
- Rarely, neoplastic or fungal masses can obstruct the nasolacrimal duct.
Related Concept Videos
Anatomy of Respiratory System I: Upper Respiratory Tract
Nose and nasal cavity
The nose and nasal cavity represent the main external openings of the respiratory tract....
Epistaxis
Etiology
Possible causes of this condition include high blood pressure, trauma, low humidity, upper respiratory tract infections, allergies, foreign bodies, nasal inhalation of corticosteroids or illicit drugs, excessive use of decongestant nasal sprays, facial or nasal surgery, anatomic malformation, tumors, or systemic...
Nose and Nasal Cavity
Prosopagnosia
Suctioning the Nasopharyngeal Airway
Equipment Required
Cranial Bones: Lateral View
The temporal bone forms the lower lateral side of the skull. The temporal bone is subdivided into several regions. The flattened upper portion is the squamous portion of the temporal bone. Below this area and projecting anteriorly is the zygomatic process of the temporal bone, which forms the posterior portion of the zygomatic arch. Posteriorly is the mastoid portion of the temporal bone. Projecting...

