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Kim and Son: Evaluation of Bony Nasolacrimal Ducts in Koreans with Primary Acquired Nasolacrimal Duct Obstruction
Original Article

Journal of the Korean Ophthalmological Society 2017; 58(6): 634-639.

Published online: 16 June 2017

DOI: https://doi.org/10.3341/jkos.2017.58.6.634

Evaluation of Bony Nasolacrimal Ducts in Koreans with Primary Acquired Nasolacrimal Duct Obstruction

Su Yeon Kim, MD, Byeong Jae Son, MD

Department of Ophthalmology, Kyungpook National University School of Medicine, Daegu, Korea.

Address reprint requests to Byeong Jae Son, MD. Department of Ophthalmology, Kyungpook National University Hospital, #130 Dongdeok-ro, Jung-gu, Daegu 41944, Korea. Tel: 82-53-420-5810, Fax: 82-53-426-6552, supersbj@hanmail.net

Received 9 March 2017       Revised 10 April 2017       Accepted 19 May 2017

©2017 The Korean Ophthalmological Society

(open-access):

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 evaluate the morphometric differences of bony nasolacrimal ducts (BNLDs) using computed tomography (CT) in Koreans with primary acquired nasolacrimal duct obstruction (PANDO).

Methods

From March 2014 to March 2016, 40 unilateral PANDO patients and 40 control subjects were retrospectively reviewed. The axial, sagittal, and coronal planes of CT were used for image evaluation. The proximal, minimal, and distal transverse diameters (TDs) of the BNLD were assessed. The length, sagittal orientation angle of BNLD, relative lacrimal sac-BNLD angle, nasal floor-BNLD angle, and turbinate angle were investigated. In addition, the distance between the bilateral BNLD and inter-frontozygomatic suture distance were also measured.

Results

There were no morphologic differences between the PANDO and non-PANDO sides within PANDO patients. The proximal and minimum BNLD TD measurements were significantly narrower in the PANDO patients, as compared with the control group (p = 0.010 and p = 0.017, respectively). The lacrimal sac-BNLD angle, nasal floor-BNLD angle, and turbinate angle also exhibited statistically significant differences between the PANDO patients and the control group (p = 0.019, p = 0.001, and p < 0.001, respectively).

Conclusions

Although this study was performed in a small group, the narrow proximal and minimum BNLD TD in PANDO patients (in both the PANDO and non-PANDO sides) may be associated with PANDO development in Koreans. Additionally, the narrow lacrimal sac-BNLD, nasal floor-BNLD, and turbinate angle might be possible causative factors of PANDO.

Keywords: Bony nasolacrimal duct, Computed tomography, Nasolacrimal duct obstruction

Figures and Tables

Figure 1

Bony nasolacrimal duct (BNLD) measurements with computed tomography (CT). (A) Axial CT image in bone window demonstrates BNLD transverse diameter (yellow line) measurement. (B) It reveals distance between the proximal BNLD (green line). (C) It shows inter-frontozygomatic suture distance (white line).

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Figure 2

Bony nasolacrimal duct (BNLD) measurements with computed tomography (CT). (A) Sagittal CT image reveals BNLD length (orange line) and proximal, minimal, distal BNLD anteroposterior diameter (yellow lines) measurements, respectively. ‘a’ demonstrates measurement of sagittal orientation angle between long axis (white line) of BNLD and nasal floor (black line). (B) Coronal CT image shows relative lacrimal sac-BNLD orientation angle ‘b’ between long axis of lacrimal sac fossa (green line) and BNLD (white line). ‘c’ reveals angle between long axis of BNLD (white line) and nasal floor (black line). (C) It demonstrates angle (red line) between the bony inferior turbinate and upper part of the medial wall of the maxillary sinus.

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Table 1

Patient characteristics

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Values are presented as mean ± SD unless otherwise indicated.

PANDO = primary acquired nasolacrimal duct obstruction; SD = standard deviation; M = male; F = female; OD = oculus dexter; OS = oculus sinister.

*No statistical significance using a student t-test; †No statistical significance using a χ2 for independence (p < 0.05).

Table 2

Values of measurements in PANDO side, non-PANDO side, and control groups

jkos-58-634-i002

Values are presented as mean ± SD unless otherwise indicated.

PANDO = primary acquired nasolacrimal duct obstruction; BNLD = bony nasolacrimal duct; TD = transverse diameter; FZS = frontozygomatic suture; APD = anteroposterior diameter; SD = standard deviation.

*One way analysis of variance (ANOVA) test (p < 0.05). There was no statistically significant difference between PANDO side and non-PANDO side (p > 0.5, Post hoc test).

Table 3

Pearson correlation coefficients between values of measurements

jkos-58-634-i003

Values are presented as mean ± SD unless otherwise indicated.

BNLD = bony nasolacrimal duct; TD = transverse diameter; FZS = frontozygomatic suture; SD = standard deviation.

*Pearson correlation coefficient (r): p < 0.05; †Pearson correlation coefficient (r): p < 0.01.

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