Lacrimal Drainage System Problems After Rhinoplasty.

Area of Science:

• Ophthalmology
• Otorhinolaryngology

Background:

• Rhinoplasty is a common cosmetic and reconstructive surgical procedure.
• Permanent nasolacrimal system problems are a potential complication following rhinoplasty.
• Epiphora and lacrimal drainage system (LDS) issues can significantly impact patient quality of life.

Purpose of the Study:

• To report a case series of permanent nasolacrimal system problems after rhinoplasty.
• To analyze the diagnostic findings and treatment outcomes for patients with persistent epiphora post-rhinoplasty.
• To understand the incidence and characteristics of lacrimal drainage system complications following rhinoplastic surgery.

Main Methods:

• Review of medical records for patients with epiphora and a history of rhinoplasty.
• Analysis of demographics, diagnostic probing and irrigation results, CT scan findings, nasal endoscopy, and treatment data.
• Inclusion criteria: permanent epiphora (lasting >3 months or starting >3 months post-surgery) and LDS problems.

Main Results:

• Ten out of 43 referred patients had permanent epiphora and LDS problems.
• Mean time to symptoms: 10.3 months post-rhinoplasty; mean time to surgery: 22.2 months.
• Diagnostic findings included canalicular stenosis (40%), pus reflux (40%), clear reflux (40%), and partial nasolacrimal duct obstruction (20%).
• Dacryocystorhinostomy (DCR) was performed in 80% of patients; therapeutic probing/intubation in 20%.

Conclusions:

• Permanent injury to the lacrimal drainage system is a significant complication of rhinoplastic surgery.
• Management strategies should be tailored to the onset, duration, and location of the LDS injury.
• Prompt diagnosis and appropriate surgical intervention are crucial for managing post-rhinoplasty epiphora.