Nasal and Sinus Disorders in Patients with Primary Acquired Nasolacrimal Duct Obstruction (PANDO)

Document Type : Original Article

Author

Department of Ophthalmology, Eye Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.

Abstract

Introduction:
To investigate the frequency of nasal and sinus problems in patients with acquired nasolacrimal duct obstruction.
Materials and Methods:
The prospective case-control study was performed on 44 patients with primary acquired nasolacrimal duct obstruction, who were referred to oculoplastic clinics for surgery, and 50 healthy controls. All patients were evaluated with nasal endoscopy by an otolaryngologist. All endoscopic data were reported, including secretion from the middle meatus, nasal deviation, presence of a mass or polyp, turbinate hypertrophy, and concha bollosa.
Results:
The mean age of the patients was 42.02±12.04 years. The majority of participants were female (70.45%). 72.7% (32/44) of the PANDO group had varying sinus and nasal disorders. Septal deviation was the most common accompanying disorder, and it was found to be in 61.4 % (27/44) of the PANDO group compared to 36% (18/50; P=0.03) of the controls. 77.77% (28/36) of patients with unilateral nasolacrimal duct obstruction had been associated with sinus and nasal disorders.
Conclusion:
Due to the high frequency of nasal and sinus disorders in patients with acquired nasolacrimal duct obstruction, otolaryngology consultation before surgery is recommended.

Keywords

Main Subjects


  1. Dikici O, Ulutas H. Relationship Between Primary Acquired Nasolacrimal Duct Obstruction, Paranasal Abnormalities and Nasal Septal Deviation. J Craniofac Surg May/Jun 2020;31(3): 782-786. doi: 10.1097/SCS. 0000000000006108.
  2. Gul A, Aslan K, Karli R, et al. A possible cause of nasolacrimal duct obstruction: narrow angle between inferior turbinate and upper part of the medial wall of the maxillary sinus. Curr Eye Res 2016; 41:729–733
  3. McCormick A, Sloan B. The diameter of the nasolacrimal canal measured by computed tomography: gender and racial differences. Clin Experiment Ophthalmol 2009;37: 357–361.
  4. Tatlisumak E, Aslan A, Co ¨mert A, et al. Surgical anatomy of the nasolacrimal duct on the lateral nasal wall as revealed by serial dissections. Anat Sci Int 2010; 85:8–12
  5. Ali MJ, Paulsen F. Etiopathogenesis of primary acquired nasolacrimal duct obstruction. Ophthal Plast Reconstr Surg 2019;35:426–433
  6. Berger G, Balum-Azim M, Ophir D. The normal inferior turbinate: histomorphometric analysis and clinical implications. Laryngoscope 2003; 113: 1192–1198
  7. Linberg JV, McCormick SA. Primary acquired nasolacrimal duct obstrustion. A clinicopathologic report and biopsy technique.Ophthalmology 1986; 93: 1055 1063.doi:10.1016/s 01616420 (86)33620-0.
  8. Yazici H, Bulbul E, Yazici A, et al. Primary acquired nasolacrimal duct obstruction: is it really related to paranasal abnormalities? Surg Radiol Anat 2015; 37:579–584 13.
  9. Janssen AG, Mansour K, Bos JJ, Castelijns JA. Diameter of the bony lacrimal canal: normal values and values related to nasolacrimal duct obstruction: assessment with CT. Am J Neuroradiol 2001; 22:845–850
  10. Haroon Y, Saleh HA, Abou-Issa AH. Nasal soft tissue obstruction improvement after septoplasty without turbinectomy. Eur Arch Otorhinolaryngol 2013;270:2649–2655 15.
  11. Kapusuz Gencer Z, Ozkiris¸ M, Okur A, et al. The effect of nasal septal deviation on maxillary sinus volumes and development of maxillary sinusitis. Eur Arch Otorhinolaryngol 2013;270:3069–3073
  12. Chakravarti A, Naglot S, Dhawan R. Outcome of endoscopic sinus surgery in patients with symptomatic chronic rhinosinusitis with minimal changes on computerised tomography. Indian Journal of Otolaryngology and Head & Neck Surgery. 2011;63(4):359-63.
  13. Lee JS, Lee H, Kim JW, Chang M, Park M, Baek S. Association of facial asymmetry and nasal septal deviation in acquired nasolacrimal duct obstruction in East Asians. The Journal of craniofacial surgery. 2013;24(5):1544-8.
  14. Yazici H, Bulbul E, Yazici A, Kaymakci M, Tiskaoglu N, Yanik B, et al. Primary acquired nasolacrimal duct obstruction: is it really related to paranasal abnormalities? Surgical and radiologic anatomy : SRA. 2015;37(6):579-84.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

  1. Singh S, Aliam M.Sh, Ali M.J, Naik M.N Endoscopic intranasal findings in unilateral primary acquired nasolacrimal duct obstruction. Saudi J Ophthalmol Jul-Sep 2017;31(3):128-130. doi: 10.1016/j.sjopt.2017.05.013.
  2. Cervelli V, Gravante G, Colicchia GM, Grimaldi G, BottiniJ, et al. Asymptomatic lacrimal flow abnormalities in patients with septal deviations and turbinate hypertrophy. Aesthetic Plast Surg 2008;32:72–6. DOI: 10.1007/s00266-007-9009-6
  3. Eyigör H, Unsal AI, Unsal A. The role of accompanying sinonasal abnormalities in the outcome of endonasal dacryocystorhinostomy. Am J Rhinol. 2006 Nov-Dec;20(6):620-4. doi: 10.2500/ajr.2006.20.2944. PMID: 17181105.