Anatomic relationship of nasolacrimal duct and major lateral wall landmarks: cadaveric study with surgical implications

Ali, Mohammad Javed; Nayak, Jayakar V.; Vaezeafshar, Reza; Li, Gang; Psaltis, Alkis J.

doi:10.1002/alr.21345

Cited by 29 publications

(16 citation statements)

References 19 publications

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“…In a cadaveric study of diverse ethnic backgrounds (Caucasian, African-American and Asian), the mean distance from the alar rim to the NLD at the level of maxillary ostium was 43.05 ± 4.76 mm on the right and 41.25 ± 4.56 mm on the left. 19 Vertically, inferior opening was located 25.5 ± 3.9 mm (15.4-30.9 mm) below the skull base and 16.5 ± 2.7 mm (12.59-23.83 mm) above the floor of nasal cavity. In cadavers of Korean descent, it was 10.7 ± 2.7 mm above the floor of the nasal cavity.…”

Section: Discussionmentioning

confidence: 93%

Surgical Anatomy of Nasolacrimal Duct and Sac in Human Cadavers

Gupta¹,

Sahni²,

Goyal³

2014

An International Journal Clinical Rhinology

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Background: Surgical importance of the nasolacrimal duct (NLD) for both otolaryngologists and ophthalmologists cannot be overemphasized. Injury to this structure can lead to iatrogenic epiphora, synechiae formation and need for secondary lacrimal diversion procedures. Materials and methods:The present study was conducted on 27 mid-sagittal sections of head and neck of formalin fixed adult cadavers. The inferior opening of the NLD was identified and exposed. The duct and the lacrimal sac were dissected. Pertinent distances of the inferior opening of the NLD from the easily identifiable surgical landmarks were recorded, so as to accurately locate the inferior opening of the duct using a digital vernier calliper (accuracy 0.02 mm, Mitutoya, Japan). Various dimensions and angulation of the duct and lacrimal sac were measured. Results:The average length of NLD was 11.42 ± 2.45 mm and it was making an angle of 20° with the vertical plane. The duct was narrowest in caliber in its upper 1/3rd in majority (82%) of the cases. The average diameter of the inferior opening of the NLD was 3.14 mm. In two cases (7.4%), the opening was only 1.8 mm wide. The mean distance of the inferior opening of the duct was 20.7 mm from the columella, 25.5 mm below the skull base and 16.5 mm above the hard palate. The average distance between the inferior opening of the NLD and anterior end of the inferior turbinate was 14.8 mm. The mean A-P diameter of superior opening of NLD was about 3 mm. The average length and width of nasolacrimal sac at its center was 6.95 and 3.24 mm respectively. Conclusion:Detailed anatomical knowledge of the NLD is of great importance for safe and successful endonasal surgery. The present study attempts to provide useful surgical guidelines by using anatomic and positional relationships between the NLD and the major surrounding landmarks.

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Section: Discussionmentioning

confidence: 93%

Surgical Anatomy of Nasolacrimal Duct and Sac in Human Cadavers

Gupta¹,

Sahni²,

Goyal³

2014

An International Journal Clinical Rhinology

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“…The agger nasi cells are present adjacent to the lacrimal sac, whereas the ethmoidal sinus and natural maxillary sinus ostia are related to the NLD. 10,11 The true maxillary sinus ostium is less than 5 mm posterior to the NLD. During ESS, the maxillary ostia should not be opened anterior to the anterior end of the middle turbinate or anterior to the anterior maxillary line (Fig.…”

Section: Nasolacrimal Duct Injury and Epiphoramentioning

confidence: 99%

“…Although occult NLD injury was noted to occur in 15% of patients undergoing ESS, symptomatic NLD injury is rare. 10 If the NLD is crushed or partly trisected, one may elect to perform a dacryocystorhinostomy or lacrimal stenting. In case of mild extramural NLD trauma, the injury may be observed.…”

Section: Nasolacrimal Duct Injury and Epiphoramentioning

confidence: 99%

“…Many injuries do not become symptomatic (epiphora). 10 Other causes of watery eyes such as corneal erosion or inverted lash should be ruled out when patients report epiphora. If spontaneous recovery from an NLD injury does not occur, an endoscopic dacryocystorhinostomy can be performed postoperatively after confirmation of the NLD stenosis by appropriate tests.…”

Section: Nasolacrimal Duct Injury and Epiphoramentioning

confidence: 99%

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Orbital Complications Associated with the Treatment of Chronic Rhinosinusitis

Patel

Hoxworth

Lal

2015

Otolaryngologic Clinics of North America

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“…Второе физио-логическое сужение локализовано в дистальной тре-ти носослезного протока. Устье последнего нахо-дится в нескольких миллиметрах кзади от складки крыла носа [3,4,7,8].…”

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Developing the optimal protocol for balloon dacryoplasty

Федоров

Yartsev

et al. 2015

Vestn. oftal'mol.

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Anatomic relationship of nasolacrimal duct and major lateral wall landmarks: cadaveric study with surgical implications

Cited by 29 publications

References 19 publications

Surgical Anatomy of Nasolacrimal Duct and Sac in Human Cadavers

Surgical Anatomy of Nasolacrimal Duct and Sac in Human Cadavers

Orbital Complications Associated with the Treatment of Chronic Rhinosinusitis

Developing the optimal protocol for balloon dacryoplasty

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