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Bilateral nasolacrimal duct obstruction managed with endoscopic techniques
R J Wong1, R E Gliklich, P A Rubin
1Department of Otology and Laryngology, Harvard Medical School, Boston, Mass, USA.
Archives of Otolaryngology--Head & Neck Surgery
|June 25, 1998
Summary
Bilateral nasolacrimal duct obstruction can signal underlying systemic diseases like Wegener granulomatosis or sarcoidosis. Treating both the obstruction and sinus disease simultaneously improves surgical outcomes.
Area of Science:
- Ophthalmology
- Otorhinolaryngology
- Rheumatology
Background:
- Bilateral acquired nasolacrimal duct obstruction (BANDO) can be a presenting sign of systemic inflammatory or malignant conditions.
- Wegener granulomatosis, sarcoidosis, and chronic lymphocytic leukemia are among the rare systemic diseases associated with BANDO.
Observation:
- Three cases of BANDO are presented, all associated with significant paranasal sinus and intranasal disease.
- The underlying conditions identified were Wegener granulomatosis, sarcoidosis, and chronic lymphocytic leukemia.
Findings:
- Surgical dacryocystorhinostomy for BANDO demonstrated improved success rates when concurrent paranasal sinus disease was addressed.
- Endoscopic approaches facilitated simultaneous surgical treatment of both nasolacrimal and paranasal sinus pathologies.
Implications:
- Nontraumatic BANDO warrants investigation for underlying systemic diseases.
- Coexisting paranasal sinus pathology should be suspected in patients with BANDO.
- Simultaneous endoscopic management of lacrimal and sinonasal disease is recommended for optimal patient outcomes.