Journal List > J Korean Ophthalmol Soc > v.59(3) > 1010862

Chung, Jo, and Yang: The Effect of Endonasal Dacryocystorhinostomy in the Paranasal Mucocele Invading Nasolacrimal Duct

Abstract

Purpose

To evaluate the effect of endonasal dacryocystorhinostomy in the paranasal mucocele invading nasolacrimal duct.

Methods

We analyzed 252 patients who were diagnosed with paranasal mucocele from 2006 to 2017, and found 14 patients (14 eyes) who underwent endonasal dacryocystorhinostomy in the paranasal mucocele invading nasolacrimal duct. Clinical features and surgical results of the patients were analyzed retrospectively.

Results

The origins of the mucocele were frontoethmoidal sinus (seven cases, 50%) and ethmoidal sinus(seven cases, 50%). The most common symptom from the first visit was epiphora (13 cases, 92.8%); medial canthal mass (nine cases, 64.2%) was the second most common symptom. Every patient underwent endonasal dacryocystorhinostomy with rhinology and sinus surgery according to the type, size, and severity of the paranasal mucocele. Every patient showed successful irrigation in the lacrimal canalicular irrigation test and improved epiphora 6 months postoperatively.

Conclusions

When paranasal mucocele invades the orbit, it can cause diplopia, exophthalmos, extraocular muscle movement disorders, visual impairments, and increased intraocular pressure. Furthermore, if it invades the nasolacrimal duct, it can cause obstruction of the nasolacrimal duct and result in epiphora. Based on our results, endonasal dacryocystorhinostomy was an effective primary treatment.

Figures and Tables

Figure 1

Computed tomography (CT) scan image of ethmoidal mucocele invading nasolacrimal duct (white arrow). (A) Axial view of CT scan images. (B) Coronal view of CT scan images.

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Figure 2

Intranasal endoscopic view of left nasal cavity. (A) Black arrow indicates ethmoidal mucocele. (B) Left nasal cavity at 6 months after the surgery. Mucocele was successfully removed and there were no signs of recurrence.

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Table 1

Munk's score

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Table 2

Baseline characteristics of subjects and affected eyes

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Values are presented as mean ± SD unless otherwise indicated.

IOP = intraocular pressure; CVA = corrected visual acuity.

Table 3

The presentations of mucoceles invading nasolacrimal duct

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Table 4

Details of patients treated with endonasal dacryocystorhinostomy in mucocele invading nasolacrimal duct

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ENT = Otorhinolaryngology-Head and Neck Surgery; M = male; F = female; Lt. = left; INE = intranasal ethmoidectomy; Fx. = fracture; INAE = intranasal anterior ethmoidectomy; Bt. = both; Rt. = right; Ant. = anterior.

Notes

This research was supported by a grant of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute (KHIDI), funded by the Ministry of Health & Welfare, Republic of Korea (grant number: HI15C1142).

Conflicts of Interest The authors have no conflicts to disclose.

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