• Archives of Craniofacial Surgery
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• v.23 no.1
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• pp.43-47
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• 2022

Primary lymphoma originating from the lacrimal drainage system is a rare disease. Such lymphomas are mostly B-cell in origin and present nonspecific symptoms. The treatment of malignant lymphoma of the lacrimal drainage system is slightly different. We present the case of a 71-year-old woman with a painless mass below the medial canthus. Computed tomography (CT) scan of the orbit revealed a mass invading the right lacrimal sac. An incision biopsy was obtained, and the pathologic findings suggested a diagnosis of primary diffuse large B-cell lymphoma of the lacrimal sac. The patient was treated with chemotherapy and intrathecal methotrexate. After completing eight cycles of chemotherapy, the patient was followed up by a CT scan, which revealed nearly total resolution of an ill-defined enhancing mass. At the time of this case report writing, the patient is in complete remission at six months with no other complications.

• Archives of Plastic Surgery
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• v.35 no.2
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• pp.197-200
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• 2008

Purpose: A congenital lacrimal sac fistula is unusual and consists of a dimple opening below the medial canthal tendon that leads to the lacrimal sac. This anlage ducts occur when the lacrimal anlage cells proliferate and canalize rather than involute. And, the anomaly is usually not associated with any systemic abnormalities. Also congenital cleft of the earlobes is rarely seen among congenital ear anomalies. Therefore, we report rare case with symptomatic bilateral lacrimal fistula with the ear cleft. Methods: A 4-year-old boy was admitted with aggravated chronic maxillary sinusitis, recurrent chronic dacryocystitis, and epiphora. He had two minor anomalies including bilateral lacrimal fistula originated in lacrimal tear sac and unilateral transverse ear cleft. The patient had been operated with fistulectomy and perioperative antibiotics. A small vertical ellipse is made around the opening with sharp dissection. The tract is excised using the probe as the guide. Another probe is placed through the lower canaliculus to prevent the damage. A suture ligature of 6-0 Maxon is placed around the deepest point of the tract, which is then excised. Additional sutures are placed in the tissues to form a tight closure to prevent reestablishment of the fistula. The skin is closed with 6-0 Black Silk. Results: The patient recovered well without any complications such as infection, epiphora, and obstruction of lacrimal sac. Conclusion: Our case illustrates bilateral lacrimal anlage ducts in a patient with unilateral congenital ear cleft. We recommend careful evaluation of lacrimal system in these patients, especially bilateral case and other congenital anomalies. Finally, we recommend excision of the ducts when epiphora, infection, or chronic skin irritation occur.

• Korean Journal of Veterinary Research
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• v.36 no.1
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• pp.23-29
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• 1996

This study was carried out to identify the gross anatomical and radiographic characteristics of the nasolacrimal system of the Korean native goat. The results were as follows : The nasolacrimal system are composed of two lacrimal ducts, two lacrimal, canaliculus, one lacrimal sac and one nasolacrimal duct. The nasolacrimal duct was divided into proximal, middle and distal portion. The nasolacrimal duct took a straight course to be paralleled with nasal bones and opened close to the nostril on the medial surface of the alar fold. The diameter of lacrimal punctum, the length of eyelid margin to lacrimal punctum, the length of canaliculus and the diameter of lacrimal sac were 0.82~0.90mm, 1.06~1.54mm, 5.65~6.30mm and 1.77~2.06mm, respectively. The length of proximal, middle and distal nasolacrimal duct were 36.84~40.00mm, 23.53~24.31mm and 14.55~14.73mm, respectively. The diameter of the orifice of nasolacrimal duct, the length of lateral margin of nostril to orifice of nasolacrimal duct and the length of dorsum to orifice of nasolacrimal duct were 1.29~1.33mm, 12.97~12.53mm and 15.24~16.11mm. The skull index of Korean native goat was not significantly different from the length of nasolacrimal duct.

• Kosin Medical Journal
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• v.33 no.3
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• pp.358-368
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• 2018

Objectives: To identify the relationship between surgical success rate and preoperative nasal mucosal thickness around the lacrimal sac fossa, as measured using computed tomography. Methods: We reviewed 33 eyes from 27 patients who underwent endoscopic dacryocystorhinostomy after diagnosis of primary nasolacrimal duct obstruction and who were followed-up with for at least six months between 2011 and 2014. We measured preoperative nasal mucosal thickness around the bony lacrimal sac fossa using computed tomography and analyzed patient measurements after classifying them into three groups: the successfully operated group, the failed operation group, and the non-operated group. Results: Surgery failed in six of the 33 eyes because of a granuloma at the osteotomy site and synechial formation of the nasal mucosa. The failed-surgery group showed a clinically significantly greater decrease in nasal mucosal thickness at the rearward lacrimal sac fossa compared with the successful-surgery group. However, nasal mucosal thickness of fellow eyes (i.e., non-operated eyes) was not significantly different between the two groups, and the location of the uncinate process did not appear to influence mucosal thickness. In the failed group, posteriorly located mucosal thickness of operated eye fossa was thinner than that of the non-operated eyes, but not significantly so. Conclusions: Our results from this quantitative anatomical study suggest that nasal mucosal thickness is a predictor of endoscopic dacryocystorhinostomy results.

• Journal of Veterinary Clinics
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• v.27 no.5
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• pp.559-564
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• 2010

The purpose of this study was to evaluate the value of dacryoscintigraphy with Tc-99 m Pertechnetate, which is useful in functional nasolacrimal duct obstruction diagnosis in human medical science, by applying it to normal dogs. Dacryoscintigraphy was performed on six clinically healthy beagle dogs to confirm normal passage of their lacrimal ducts. The scintigraphic images of both lacrimal system were obtained at 5 min, 10 min, and 20 min after Tc-99 m Pertechnetate administration, respectively. If lacrimal duct does not come into view within 20 min, delayed images at 30min, 45min and 60 min were gained. After drawing ROI of left and right canaliculus, lacrimal sac, and nasolacrimal duct acquired after dacryoscintigraphy, we measured each counting rate and developed a counting rate table for each time interval. Of the total of 12 places, 10 (83.3%) showed patency within 20 min, and 11 (91.6%) showed patency within 30 min. In one dog, a functional obstruction of right lacrimal canal was observed. Dacryoscintigraphy could provide useful information about functional and anatomical lacrimal duct obstruction in veterinary medicine as well as in clinical research.

• Archives of Craniofacial Surgery
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• v.11 no.1
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• pp.41-44
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• 2010

Purpose: The epicanthus is a specific feature in Asian. Many techniques have been described to eliminate the epicanthal fold: resection of glabellar skin, resection of medial canthal skin, V-Y advancement, V-W technique, modified Z-plasty, multiple Z-plasties, and others. The authors observed postoperative epiphora after correction of epicanthal fold by periciliary skin flap without damaging lacrimal duct. Methods: A 19-year-old woman underwent non-incisional blepharoplasty, septorhinoplasty, and periciliary epicanthoplasty. On her history, she didn't have any symptom of epiphora preoperatively. And there was no specific complaint of epiphora during the postoperative two weeks. However epiphora got worse from one month after the surgery. She was out of this country, so the patient re-visited the clinic on the postoperative six months for this on-going symptom. On an ophthalmologic examination, patient's lacrimal duct and sac was intact but both lacrimal puncta of the patient were covered with a thin membrane. This membrane was punctuated by a 25 gauge needle and dilated with a standard dilator. Results: After ophthalmologic treatment, no recurrence was observed during five weeks of follow-up periods. Conclusion: Both lacrimal puncta of the patient were only covered with membranes. And we could not confirm the direct relationship between periciliary epicanthoplasty and postoperative epiphora. The probable factors will be a predisposing narrowed punctum, post operative peri-punctal edema and decrease in muscular function of orbicularis oculi.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.14 no.4
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• pp.322-326
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• 1992

Epiphora is overflow of tears due to obstruction of lacrimal duct. Dacryocystorhinostomy is the most common procedure to eliminate the epiphora secondary to complete or partial obstruction of the nasolacrimal duct. The procedure is to artificially create passage between lacrimal sac and nasal cavity. Especially, epiphora would be accompany often by nasolacrimal duct obstruction when trauma of oromaxillofacial area lead to nasal fracture, medial wall fracture of orbit. Therefore in this case there are many case to perform dacryocystorhinostomy because probing and tubing is difficult to resolve the epiphora. We performed 4 cases of dacryocystorhinostomy for adult nasolacrimal duct obstruction from May 1991 to October 1991. The results were very satisfactory in all the case. Epipora disappeared in all case.

• Archives of Plastic Surgery
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• v.37 no.4
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• pp.504-508
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• 2010

Purpose: Traumatic telecanthus can result from nasoethmoid-orbital fractures. Repair of the medial canthal tendon (MCT) using transnasal wiring is regarded as a choice of method to treat telecanthus, however, is often complicated by incomplete anchoring and drift of canthus, extrusion of wire, in-fracture of orbital bone, and eye damage. The authors introduced oblique transnasal wiring method through the Hiraga's epicanthopalsty incision instead of well-known classical bicoronal approach. Methods: Five patients with traumatic telecanthus were treated with this method. Though the Hiraga's epicanthoplasty incision, we could approach the operative field; the medial orbital wall and detached MCT. Oblique transnasal wiring was performed as following steps. After slit skin incision on the contralateral nasal recession area, drill holes were made from this point to the superior and posterior point of lacrimal sac of deformed eye. A 2-0 wire was double-passed through the holes and MCT. Traction was applied to ensure pulling the MCT and the wires were twisted in the contralateral nose, securing the MCT in the correct position. Results: All patients except 1 person showed improvement and rapid recovery. On average each canthus was moved 5.6 mm medially. In all cases, there were no eyelashes disappear, lacrimal canaliculitis, lacrimal duct injury, or infections. Conclusion: The Hiraga's epicanthoplasty incision could give sufficient operative field to reattach the MCT in traumatic telecanthus patients. And the oblique transnasal wiring technique is effective for the Asians who have flat nose and exophthalmic eye. The authors conclude that this technique could be a simple, safe and scarless method to correct traumatic telecanthus.

• Korean Journal of Ichthyology
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• v.26 no.4
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• pp.281-287
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• 2014

An olfactory organ in Scartelaos gigas, so-called mudskipper known as adaptation to an amphibious lifestyle, was investigated anatomically and histologically. S. gigas possessed the paired olfactory organ comprising respectively the one elongated canal and two nasal sacs, lacrimal and ethmoidal nasal sac. The sensory epithelium developed partly in the canal contained four distinct types of cells: (1) receptor cell with 3 to 4 cilia in number, (2) supporting, (3) basal, (4) mucus cell. The sensory epithelium was also of transitional layer as multi cellularity structure. The non-sensory epithelium had no sensory elements. The two nasal sacs possessed typically a lot of mucin droplets. These results might be considered that anatomical structure and histological characters of the olfactory organ showing in S. gigas is adapted to semi-aquatic life associated with its ecological habit and habitat.

• The Korean Journal of Nuclear Medicine
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• v.34 no.6
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• pp.508-515
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• 2000

Purpose: To evaluate the value of dacryoscintigraphy in the assessment of patients with a clinical diagnosis of functional nasolacrimal duct obstruction. Materials and Methods: Dacryoscintigraphy was performed in symptomatic 35 lacrimal drainage systems in 18 patients (age range: $37{\sim}76$, 8 males, 10 females) that were patent on syringing. Results: Abnormalities were detected with dacryoscintigraphy in 75.8% of systems. The positive scintigrams were subdivided into those demonstrating prelacrimal sac delay (31.8%), delay at the lacrimal sac/junction (40.9%), or delay within the duct (21%). Conclusion: Dacryoscintigraphy is noninvasive useful technique in the assessment of the functional nasolacrimal duct obstruction and very sensitive at detecting abnormalities in patients with lid laxity caused by senile change and facial nerve palsy.