Bilateral nasolacrimal duct obstruction managed with endoscopic techniques

We present 3 cases of bilateral acquired nasolacrimal duct obstruction secondary to Wegener granulomatosis, sarcoidosis, and chronic lymphocytic leukemia. In all cases significant paranasal sinus and intranasal disease coincided with bilateral nasolacrimal duct obstruction. Surgical treatment of the nasolacrimal duct obstruction with dacryocystorhinostomy was more successful if the paranasal sinus disease was also treated. Nontraumatic bilateral nasolacrimal duct obstruction heralds unusual underlying systemic diseases, and coexisting paranasal sinus disease should be suspected. The simultaneous surgical treatment of both lacrimal and paranasal sinus disease through an endoscopic approach is advocated.