Dacryocystitis Secondary to An Iatrogenic Foreign Body in the Lacrimal Apparatus

Gupta, Deepak; Whittet, H. B.; Sood, S; Maitra, Suchir

doi:10.1177/014556130908800708

Cited by 8 publications

(8 citation statements)

References 4 publications

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“…To date, a piece of metallic dilator, silicone stent, and punctal plug that was accidentally inserted into the lacrimal system, self-insertion of a fishing line, gauze, and retained Griffiths’ collar button were detected in the lacrimal system. 3 4 5 6 7 8 9 10 Similar to our case, Choi et al . reported a case of acute dacryocystitis that developed after same sided ethmoidal sinus reconstruction because of facial trauma.…”

Section: Discussionsupporting

confidence: 88%

A surprise in the lacrimal sac

Yüksel¹,

Akçay²,

Kılıçarslan³

et al. 2016

Middle East Afr J Ophthalmol

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To present a case with recurrent dacryocystitis as an unusual complication of medial orbital wall fracture repair with cartilage tissue graft. A 20-year-old male had facial trauma and underwent surgery to reconstruct right medial orbital wall fracture. During follow–up, he presented with continuous epiphora, mucopurulent discharge from the right eye. A thorough history taking indicated that medial orbital fracture was reconstructed with postauricular cartilage. We planned a standard external dacryocystorhinostomy (DCR). During the creation of lacrimal sac flaps, hard tissue was noted in the lacrimal sac. This tissue was excised and sent for pathological examination. The pathological examination revealed cartilage tissue. There were no further ipsilateral symptoms or complications after DCR. In patients with lacrimal system injury related to orbital wall fracture, iatrogenic foreign bodies in the lacrimal sac should be considered in patients with recurrent dacryocystitis who had reconstructive surgery for facial and orbital trauma.

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Section: Discussionsupporting

confidence: 88%

A surprise in the lacrimal sac

Yüksel¹,

Akçay²,

Kılıçarslan³

et al. 2016

Middle East Afr J Ophthalmol

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show abstract

“…9 Moreover, there are several widely accepted methods to greatly decrease the risk of the contracture of the fistula, including use of intraoperative mitomycin C, 12 creation of a large osteotomy, [13][14][15][16] and extensive suturing of the nasal mucosal flaps, [13][14][15] all of which may make the Griffiths' stent unnecessary. [1][2][3][4][5][6] The present patient had persistent epiphora and recurrent dacryocystitis, which had been attributed to recurrent stenosis of the nasolacrimal ostium. 9,11 Patients with lacrimal foreign bodies usually present with partial or intermittent lacrimal sac obstruction and recurrent dacryocystitis.…”

Section: Commentmentioning

confidence: 62%

“…9 Foreign bodies in the lacrimal system are uncommon and frequently undiagnosed. [1][2][3][4][5][6] Here, we describe a case of recurrent dacryocystitis resulting in the spontaneous extrusion of a forgotten Griffiths' collar button stent through the lacrimocutaneous fistula 7 years after an endonasal DCR. 6 Complications of foreign bodies include granuloma development and extrusion.…”

Section: Introductionmentioning

confidence: 99%

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Recurrent Dacryocystitis and Lacrimocutaneous Fistula Caused by a Retained Griffiths’ Collar Button Stent

Çömez¹,

Güçlü

Gencer³

et al. 2013

Orbit

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A 42-year-old man presented with a white plastic-like material exposed in the left medial canthal area, with a fistula and purulent discharge. He had undergone endonasal dacryocystorhinostomy 7 years earlier for left eye epiphora; he had persistent postoperative epiphora and recurrent dacryocystitis despite multiple drainage attempts and antibiotics elsewhere. Computed tomography showed bilateral enlarged cystic lacrimal sacs, with a well-defined contoured tunnel-like hole at the center of the left sac. Treatment included excision of the foreign body, which was a Griffiths' collar button nasolacrimal stent, excision of the fistula tract, and revision dacryocystorhinostomy with implantation of bicanalicular silicone stent. He recovered with no further symptoms or complications. This case highlights the importance of follow-up for removal of an implanted Griffiths' stent after dacryocystorhinostomy. Patients with recurrent dacryocystitis may benefit from a detailed history of previous surgery, careful examination, and imaging to evaluate for endogenous and exogenous foreign bodies such as lacrimal sac calculi, and retained lacrimal sac stents.

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“…In patients with a history of intubation with silicone stents or DCR, pieces of silicone tubing [ 6 ], a Griffiths' collar button stent used to maintain the nasal ostium [ 7 ], and retained gauze [ 8 ] have been identified in the lacrimal system. Other iatrogenic foreign bodies that have been reported include a piece of a metallic punctal dilator [ 9 ], and more common than any of the above, retained intracanalicular plugs [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

Retained Herrick Plug

Hellman

Strong

Lin

2018

Case Rep Ophthalmol

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A 79-year-old female with a history of keratoconjunctivitis sicca presented with several years of epiphora of both eyes. Thirteen years earlier, intracanalicular Herrick lacrimal plugs (Lacrimedics, Eastsound, WA, USA) had been placed in both eyes to treat her dry eye syndrome. After 13 years the patient felt the epiphora was intolerable and underwent endoscopic dacryocystorhinostomy (DCR) of the left, then the right side. Intraoperatively, during the right endoscopic DCR, a Herrick lacrimal plug was found in the common canaliculus into the lacrimal sac. Postoperatively, the patient did well with improved epiphora. The Herrick plug is designed to be intracanalicular, and this case illustrates that the plug can migrate and be retained for many years. Collared punctal plugs have a lower risk of this type of complication.

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Dacryocystitis Secondary to An Iatrogenic Foreign Body in the Lacrimal Apparatus

Cited by 8 publications

References 4 publications

A surprise in the lacrimal sac

A surprise in the lacrimal sac

Recurrent Dacryocystitis and Lacrimocutaneous Fistula Caused by a Retained Griffiths’ Collar Button Stent

Retained Herrick Plug

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