Bony nasolacrimal duct dehiscence in functional endoscopic sinus surgery: radiological study and discussion of surgical implications

J Laryngol Otol. 2015 Jul:129 Suppl 3:S35-40. doi: 10.1017/S0022215115000778. Epub 2015 Apr 8.

Abstract

Objectives: To analyse the radiological features of the bony nasolacrimal duct before and after functional endoscopic sinus surgery, and document the incidence of surgically induced dehiscence.

Methods: A retrospective case series analysis was conducted of 63 consecutive patients who underwent uncinectomy as a part of 118 functional endoscopic sinus surgical procedures. All patients underwent pre- and post-operative computed tomography scans. Axial computed tomography images at the level of maxillary sinus were evaluated for the presence of bony nasolacrimal duct dehiscence, osteitis and completeness of uncinectomy.

Results: The rate of nasolacrimal duct dehiscence prior to surgery was 6.8 per cent (8 out of 118 cases). Nasolacrimal duct dehiscence as a consequence of surgery was observed in 3.3 per cent of cases (4 out of 118), with a further 4.2 per cent (5 out of 118) showing post-operative reactive bony change of the nasolacrimal duct in the absence of dehiscence.

Conclusion: The incidence of nasolacrimal duct injury observed was much lower than that previously reported in the literature.

Keywords: CT Scan; Complications; Dehiscence; FESS; Lund-Mackay Scores; Nasolacrimal Duct; Sinus Surgery; Surgical Wound; X-Ray.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Endoscopy / adverse effects
  • Endoscopy / methods
  • Female
  • Humans
  • Male
  • Maxillary Sinus / surgery*
  • Middle Aged
  • Nasolacrimal Duct / diagnostic imaging*
  • Nasolacrimal Duct / pathology*
  • Postoperative Complications / etiology
  • Retrospective Studies
  • Rhinitis / surgery*
  • Sinusitis / surgery*
  • Surgical Wound Dehiscence / diagnostic imaging*
  • Surgical Wound Dehiscence / etiology
  • Tomography, X-Ray Computed
  • Treatment Outcome
  • Young Adult