When did Theodoric I die?
When did Theodoric II die?
When was Theodoric of Freiberg born?
Nasolacrimal duct obstruction is the obstruction of the nasolacrimal duct and may be either congenital or acquired. Obstruction of the nasolacrimal duct leads to the excess overflow of tears called epiphora.
When did Theodoric of Freiberg die?
When did Theodoric Borgognoni die?
When was Theodoric Borgognoni born?
When did Antipope Theodoric die?
When was Theodoric the Great born?
When did Theodoric the Great die?
When did Theodoric Strabo die?
Who established the kingdom of the Ostrogoths in Italy?
Who was the Ostrogoth ruler who deposed Odoacer?
The Ostrogoth ruler who deposed Odoacer was?
Who was the ostrogoth king who took control of Italy?
When did Theodoric the Great the king of the Ostrogoths die?
What duct is formed by the merger of the cystic duct and the common hepatic duct?
Who discovered the colours of the rainbow?
The rainbow was discovered by Theodoric of Frielburg in the 14th Century. Read More
As played by Steve Martin on SNL Theodoric of York was usually plying?
How did the Byzantine emperor reward Clovis for fighting the Theodoric?
![Gentle Obstruction Of The Ducts Gentle Obstruction Of The Ducts](http://pediatricophthalmologypa.com/wp-content/uploads/2014/02/Tear-Duct-Nasolacrimal-Duct-by-3MD-Media-Marketing-MD.jpg)
What is attached to the hepatic duct?
Hepatic duct is attached with liver. The union of hepatic duct and cystic duct forms common bile duct. Read More
Which duct connects the gallbladder to the common hepatic duct?
It is the cystic duct that connects the gallbladder to the common hepatic duct. This connection forms the common bile duct. Read More
What joins the cystic duct together to form the common bile duct?
The hepatic duct and the cystic duct join together and form the common bile duct Read More
The common bile duct consist of?
What has the author Conrad Brodribb written?
Conrad Brodribb has written: 'Theodoric Rood' Read More
What is the nasolacrimal duct?
In animals, the nasolacrimal duct is a tear duct. This duct carries tears from the lacrimal sac to the nasal cavity. Read More
The fusion of the hepatic duct and the cystic duct forms the?
What happened to the duct from the gallbladder on a pig?
The duct from a gallbladder on a pig is connected to the bile duct. Bile is transported via the cystic duct to the gallbladder. Read More
Duct transporting bile from gallbladder to common bile duct?
What is the duct that carries sperm from the testicles to the ejaculatory duct?
What are some words that contain duct?
seDUCTive, DUCT tape, air DUCT, proDUCTive Read More
Theodoric the ostrogoth established his capital city in?
He set up his capital in Ravenna. ravenna Read More
Which duct joins the common bile duct as it enters the duodenum at the ampulla of vater?
What type of duct would you fit on a warm air unit?
Duct tape business names?
What area of the duodenum where the common bile duct and the pancreatic duct empty is called?
The Ampulla of Vater..This is the duodenum where the common bile duct and the pancreatic duct empty. Read More
What blood vessel does the right lymphatic duct and thoracic duct empty lymph?
The right lympathic duct empties into the right subclavian vein and the left lympathic duct (thoracic duct) empties into the left subclavian vein. Read More
What is another name for the parotid duct?
Stensen's duct is another name for the parotid salivary gland duct Read More
What 2 ducts combine to make up the common bile duct?
What does it mean if you have no bile duct dilation?
'no bile duct dilation' means the diameter if the bile duct is normal. Read More
What is function of the cystic duct?
The cystic duct lies between the gallbladder and the common bile duct. Its' function is to transport bile from the gall bladder to the common bile duct. Read More
Where does the name thayer originate from?
[per meaning-of-names.com] 'descendant of Thaider (people; army); the son of Theodoric.' Read More
What does the name 'Dereck' mean?
It is short for Theodoric, which is Germanic for 'rule by the people'. Read More
Bile and pancreatic juices enter what the through the common bile duct and the pancreatic duct?
bile and pancreatic juices enter the _______ through the common bile duct and the pancreatic duct Read More
How to calculate duct area?
To calculate duct area, multiply the width of the duct by the height of the duct. This gives you the area in inches or centimeters, depending on the unit of measure used for the calculation. Read More
Who is duct tape man?
duct tape man is tyler thielen. that lives in Missouri and masters duct tape Read More
What is the function of common hepatic duct?
Joins the two-way cystic duct to form the common bile duct Read More
How do you say duct tape in spanish?
What is the duct that leaves the gallbladder?
Is duct tape recyclable?
Which bile duct leads into and out of the gallbladder?
(Redirected from Congenital lacrimal duct obstruction)
Nasolacrimal duct obstruction | |
---|---|
Tear system consists of lacrimal gland (a), punctums (b,e), canalicules (c,f), lacrimal sac (g,d). Tear is then drained through nasolacrimal duct (not shown in the image) into nasal cavity | |
Specialty | Ophthalmology |
Nasolacrimal duct obstruction is the obstruction of the nasolacrimal duct and may be either congenital or acquired. Obstruction of the nasolacrimal duct leads to the excess overflow of tears called epiphora.[1]
- 2Cause
- 3Diagnosis
- 4Management
Sign and symptoms[edit]
Excessive tearing is the most common complaint of patients with nasolacrimal duct obstruction, followed by acute or chronic infections.[2] Pain at the side of the nose suggests dacryocystitis.
Nasolacrimal duct obstruction is more common with increasing age and more common in females than males.[2]
Cause[edit]
Involutional stenosis[edit]
Involutional stenosis is probably the most common cause of nasolacrimal duct obstruction in older people. It affects women twice as frequently as men. Although the inciting event in this process is unknown, clinicopathologic study suggests that compression of the lumen of the nasolacrimal duct is caused by inflammatory infiltrates and edema. This may be the result of an unidentified infection or possibly an autoimmune disease.[citation needed]
Dacryolith[edit]
Dacryoliths or cast formation, within the lacrimal sac can also produce obstruction of the nasolacrimal duct.
Sinus disease[edit]
Sinus disease often occurs in conjunction with, and in other instances may contribute to the development of nasolacrimal ductbobstruction. Patients should be asked about previous sinus surgery, as the nasolacrimal duct is sometimes damaged when the maxillary sinus ostium is being enlarged anteriorly.
Trauma[edit]
Naso-orbital fractures may involve the nasolacrimal duct. Early treatment by fracture reduction with stenting of the entire lacrimal drainage system should be considered. However, such injuries are often not recognized or are initially neglected as more serious injuries are managed. In such cases, late treatment of persistent epiphora usually requires dacryocystorhinostomy.
Inflammatory disease[edit]
Granulomatous disease, including sarcoidosis, granulomatosis with polyangiitis, and midline granuloma, may also lead to nasolacrimal ductbobstruction.
Lacrimal plugs[edit]
As with similar cases of canalicular obstruction, dislodged punctual and canalicular plugs can migrate to and occlude the nasolacrimal duct.
Neoplasm[edit]
Neoplasm should be considered in any patient presenting with nasolacrimal duct obstruction. In patients with atypical presentations, including younger age and male gender, further workup is appropriate. Bloody punctual discharge or lacrimal sac distension above the medial canthal tendon is also highly suggestive of neoplasm.
Congenital[edit]
Congenital nasolacrimal duct obstruction, or dacryostenosis, occurs when the lacrimal duct has failed to open at the time of birth, most often due to an imperforate membrane at the valve of Hasner.[3] Around 6% of infants have congenital nasolacrimal duct obstruction, or dacryostenosis, usually experiencing a persistent watery eye even when not crying. If a secondary infection occurs (Dacryocystitis), purulent (yellow / green) discharge may be present.
Most cases resolve spontaneously, with antibiotics reserved only if conjunctivitis occurs. Lacrimal sac massage has been proposed as helping to open the duct, though this is not always successful.[4] The aim of massage is to generate enough hydrostatic pressure (downward, toward the nose) to 'pop' open any obstruction. Additional massage may then be performed up toward the lacrimal punctum, in order to express any infectious material out of the nasolacrimal sac. When discharge or crusting is present, the lids should be gently cleaned using cooled pre-boiled water or saline.
Referral to an ophthalmologist is indicated if symptoms are still present at 12 months, or sooner if significant symptoms or recurrent infections occur. Nasolacrimal duct probing may be performed in the office setting (usually from 4 to 8 months of age) or under general anesthesia in an operating room for older patients. The success rate of probing is higher for younger children. A silastic tube or stent may be employed along with probing to maintain tear duct patency.[5] A systematic review comparing immediate probing with deferred probing found that in children with unilateral nasolacrimal duct obstruction, immediate probing resulted in a higher success rate of treatment compared to deferred probing.[6]
Diagnosis[edit]
Evaluation is in the form of a dye disappearance test followed by irrigation test. By using this sequence (with modifications) as a guide, the physician can frequently streamline diagnostic testing.
Dye disappearance test[edit]
The dye disappearance test is useful for assessing the presence or absence of adequate lacrimal outflow, especially in unilateral cases. It is more heavily relied upon in children, in whom lacrimal irrigation is impossible without deep sedation. Using a drop of sterile 2% fluorescein solution or a moistened fluorescein strip, the examiner instills fluorescein into the conjunctival fornices of each eye and then observes the tear film, preferably with the cobalt blue filter of the slit lamp. Persistence of significant dye and, particularly asymmetric clearance of the dye from the tear meniscus over a 5-minute period indicate an obstruction. If the dye disappearance test result is normal, severe lacrimal drainage dysfunction is highly unlikely. The Jones tests are variations of the dye disappearance test.
Irrigation test[edit]
Flushing the nasolacrimal duct in a cat.
In irrigation test, a lacrimal irrigation cannula is passed into the punctum and advanced through the canaliculus to the lacrimal fossa. Clear water or saline is then irrigated through the cannula. If fluid passes into the nose without reflux out of the opposite canaliculus, the system is patent. If no fluid passes but it all comes back through either punctum, nasolacrimal duct obstruction is present.
Management[edit]
Intubation and stenting[edit]
Some clinicians believe that partial stenosis of the nasolacrimal duct with symptomatic epiphora sometimes responds to surgical intubation of the entire lacrimal drainage system. This procedure should be performed only if the tubes can be passed easily. In complete nasolacrimal duct obstruction, intubation alone is not effective, and a dacryocystorhinostomy should be considered.
Dacryocystorhinostomy[edit]
A dacryocystorhinostomy is the treatment of choice for most patients with acquired nasolacrimal duct obstruction. Surgical indications include recurrent dacryocystitis, chronic mucoid reflux, painful distension of the lacrimal sac, and bothersome epiphora. For patients with dacryocystitis, active infection should be cleared, if possible, before a dacryocystorhinostomy is performed.[1]
See also[edit]
References[edit]
- ^ abMyron Yanoff; Jay S. Duker (2009). Ophthalmology (3rd ed.). Mosby Elsevier. pp. 1482–1487. ISBN9780323043328.
- ^ abJawaheer L, MacEwen CJ, Anijeet D (2017). 'Endonasal versus external dacryocystorhinostomy for nasolacrimal duct obstruction'. Cochrane Database Syst Rev. 2: CD007097. doi:10.1002/14651858.CD007097.pub3. PMID28231605.CS1 maint: Uses authors parameter (link)
- ^Blocked tear ducts in infants, Pediatric Views, June 2006 http://www.childrenshospital.org/views/june06/blocked_tear_ducts.html
- ^Young JD, MacEwen CJ (1997). 'Managing congenital lacrimal obstruction in general practice'. BMJ. 315 (7103): 293–6. doi:10.1136/bmj.315.7103.293. PMC2127215. PMID9274552.
- ^Engel JM, Hichie-Schmidt C, Khammar A, Ostfeld BM, Vyas A, Ticho BH (2007). 'Monocanalicular silastic intubation for the initial correction of congenital nasolacrimal duct obstruction'. J Aapos. 11 (2): 183–186. doi:10.1016/j.jaapos.2006.09.009. PMID17307001.
- ^Petris C, Liu D (2017). 'Probing for congenital nasolacrimal duct obstruction'. Cochrane Database of Systematic Reviews. 7: CD011109. doi:10.1002/14651858.CD011109.pub2. PMC5580992. PMID28700811.CS1 maint: Uses authors parameter (link)
External links[edit]
Classification |
|
---|---|
External resources |
Retrieved from 'https://en.wikipedia.org/w/index.php?title=Nasolacrimal_duct_obstruction&oldid=900186667#Congenital'