A Case of Nasolacrimal Duct Obstruction after Two-Jaw Surgery

Seok Kang Wan; Ahn Min

doi:10.3341/jkos.2013.54.5.794

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Wan and Min: A Case of Nasolacrimal Duct Obstruction after Two-Jaw Surgery

Original Article

J Korean Ophthalmol Soc 2013;54(5):794-797.

Published online: 7 September 2013

DOI: https://doi.org/10.3341/jkos.2013.54.5.794

A Case of Nasolacrimal Duct Obstruction after Two-Jaw Surgery

Seok Kang Wan, MD, Ahn Min, MD, PhD

¹Department of Ophthalmology, Chonbuk National University Medical School, Jeonju, Korea

Address reprint requests to Min Ahn, MD, PhD Department of Ophthalmology, Chonbuk National University Hospital #20 Geonji-ro, Deokjin-gu, Jeonju 561-712, Korea Tel: 82-63-250-1878, Fax: 82-63-250-1960, E-mail: ahnmin@jbnu.ac.kr

Received 31 August 201228 October 2012 Accepted 25 February 2013

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To describe a case of nasolacrimal duct obstruction after two-jaw surgery.

Case summary

A 22-year-old woman presented with a 1-year history of epiphora after two-jaw surgery. Orbital CT showed 5 mm of focal soft tissue at the level of the distal nasolacrimal duct. Dacryocystography showed complete ob-struction at the nasolacrimal duct level. Thus a nasolacrimal duct obstruction was diagnosed by physical and radiologic examination.

Conclusions

In patients with epiphora who have undergone two-jaw surgery, precise examination and treatment is re-quired in order to exclude nasolacrimal duct obstruction.

Keywords: Epiphora, Nasolacrimal duct obstruction, Two-jaw surgery

References

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Figure 3.

A Dacryocystography of the patient shows complete obstruction of the right nasolacrimal duct.

Figure 4.

The osteotomy line of conventional Lefort surgery is shown by the dotted line. The inferior orifice of the nasolacri-mal canal (black arrow) is located at the top of the curved in-sertion of the inferior turbinate.

Figure 1.

A general sequence of two-jaw surgery. After osteotomy of the maxilla and mandibule, trimming of the bone for adjustments should be done (B). Repo- sitioning of the bones (C). Bone plates and screws used for fixation of the bones (D).

Figure 2.

A continuous coro-nal section of facial CT (A-D) shows nasolacrimal duct (long arrow) and fracture line of Lefort surgery (small arrow). A right nasolacrimal duct opening is obstructed with soft tissue (D).

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