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Persistent epiphora after endonasal ENT surgery: CT dacryography findings.
T H Nguyen1, N Venturelli1, S Espinoza1
1Department of Neuro Imaging, Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, Paris, France.
Journal Francais D'Ophtalmologie
|February 6, 2022
Summary
Persistent epiphora after endonasal surgery can stem from damage to the nasolacrimal duct. CT dacryography helps identify these surgical site changes, guiding preventative measures.
Area of Science:
- Ophthalmology
- Otorhinolaryngology
- Radiology
Background:
- Persistent epiphora (tearing) is a potential complication following endonasal ENT surgery.
- Understanding the anatomical causes of post-surgical epiphora is crucial for patient management.
Purpose of the Study:
- To analyze the CT dacryography features of persistent epiphora after endonasal surgery.
- To identify the relationship between surgical procedures and lacrimal canal involvement.
Main Methods:
- Retrospective study of 76 patients with persistent epiphora post-endonasal ENT surgery.
- CT dacryography with 2D/3D reconstructions and virtual endoscopy of nasosinusal cavities and lacrimal canal.
Main Results:
- Postsurgical changes included middle meatal antrostomy, ethmoidectomy, and turbinectomy.
- 46% of patients had the lacrimal canal distant from the surgical site; 43% showed surgical site changes.
- Epiphora was linked to mucosal hypertrophy constricting the lacrimal canal or direct surgical site injury.
Conclusions:
- Involvement of the nasolacrimal duct is a rare cause of persistent tearing after endonasal surgery.
- Intraoperative localization of the nasolacrimal duct is vital before resecting the uncinate process or inferior turbinate.
- Preoperative CT imaging can help predict and prevent such complications.
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