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Epistaxis Complicated by Hemolacria: A Case Report.

Anne E Drake1, Clifford D Packer2,3

  • 1Case Western Reserve University School of Medicine, Cleveland, OH Aed65@case.edu.

Clinical Medicine & Research
|August 21, 2020
PubMed
Summary
This summary is machine-generated.

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Hemolacria, or bloody tears, can occur after nasal tamponade for nosebleeds. This rare condition often resolves with conservative treatment, suggesting a link to specific anatomical variations in the lacrimal system.

Area of Science:

  • Ophthalmology
  • Otorhinolaryngology

Background:

  • Hemolacria is a rare complication associated with epistaxis (nosebleeds).
  • Nasal compression or tamponade is a common treatment for epistaxis.

Observation:

  • An 81-year-old male with end-stage renal disease developed hemolacria after nasal tamponade for persistent epistaxis.
  • The patient was treated with a "Rhino Rocket" nasal tamponade device.
  • Hemolacria resolved following intranasal oxymetazoline treatment.

Findings:

  • Hemolacria post-nasal tamponade is hypothesized to result from retrograde flow from inferior nasal turbinates to the lacrimal system.
  • Anatomical connections via Hasner's and Rosenmüller's valves may facilitate this retrograde flow.
  • Predisposition to hemolacria may be linked to congenital absence or acquired incompetence of lacrimal valves.
Keywords:
AnatomyHemolacriaNasolacrimal duct

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Implications:

  • Physicians should recognize hemolacria as a usually self-limited complication of epistaxis treatment.
  • Conservative measures can effectively manage hemolacria in the context of nasal hemorrhage.
  • Awareness of potential anatomical predispositions is crucial for understanding hemolacria occurrence.