Dacryocystorhinostomy Workup

  • Author: S Valentine Fernandes, MBBS, MCPS, FRCSEd, FRACS, FACS, LLB; Chief Editor: Arlen D Meyers, MD, MBA   more...
 
Updated: Mar 5, 2012
 

Imaging Studies

Dacryocystography allows assessment of the lacrimal passage patency by radiopaque dye techniques.

CT scanning delineates anatomy and detects unrecognized disease in the paranasal sinuses and nose.

CT scanning and dacryocystography further define the anatomy of the lacrimal drainage system.

MRI and dacryocystography allow a better view in the absence of bony shadows.

Lacrimal scintigraphy using gamma camera technology allows assessment of functional tear drainage.

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Other Tests

Perform a complete ophthalmologic examination, including testing of visual acuity and visual fields and slit lamp examination.

Perform nasal endoscopy to identify a possible cause for lacrimal obstruction and to assess the feasibility of endoscopic manipulation.

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Diagnostic Procedures

Metal probing and irrigation of the lacrimal drainage system allows confirmation of the diagnosis.

Fluorescein dye irrigation of the lacrimal puncta and detection of the dye in the inferior meatus eliminate a diagnosis of complete blockage.

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Proceed to Treatment & Management
 
 
Contributor Information and Disclosures
Author

S Valentine Fernandes, MBBS, MCPS, FRCSEd, FRACS, FACS, LLB  Conjoint Senior Clinical Lecturer, Department of Otorhinolaryngology, Newcastle University; Senior Consultant Surgeon, Department of Otorhinolaryngology-Head and Neck Surgery, John Hunter, Warners Bay Private Hospitals, Australia

S Valentine Fernandes, MBBS, MCPS, FRCSEd, FRACS, FACS, LLB is a member of the following medical societies: American College of Surgeons

Disclosure: Nothing to disclose.

Specialty Editor Board

B Viswanatha, MBBS, MS, DLO  Professor of Otolaryngology (ENT), Chief of ENT III Unit, Sri Venkateshwara ENT Institute, Victoria Hospital, Bangalore Medical College and Research Institute; PG and UG Examiner, Manipal University, India and Annamalai University, India

B Viswanatha, MBBS, MS, DLO is a member of the following medical societies: Association of Otolaryngologists of India, Indian Medical Association, and Indian Society of Otology

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD  Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Stephen G Batuello, MD  Consulting Staff, Colorado ENT Specialists

Stephen G Batuello, MD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery, American College of Physician Executives, American Medical Association, and Colorado Medical Society

Disclosure: Nothing to disclose.

Christopher L Slack, MD  Private Practice in Otolaryngology and Facial Plastic Surgery, Associated Coastal ENT; Medical Director, Treasure Coast Sleep Disorders

Christopher L Slack, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, and American Medical Association

Disclosure: Nothing to disclose.

Chief Editor

Arlen D Meyers, MD, MBA  Professor of Otolaryngology, Dentistry, and Engineering, University of Colorado School of Medicine

Arlen D Meyers, MD, MBA is a member of the following medical societies: American Academy of Facial Plastic and Reconstructive Surgery, American Academy of Otolaryngology-Head and Neck Surgery, and American Head and Neck Society

Disclosure: Covidien Corp Consulting fee Consulting; US Tobacco Corporation Unrestricted gift Unknown; Axis Three Corporation Ownership interest Consulting; Omni Biosciences Ownership interest Consulting; Sentegra Ownership interest Board membership; Medvoy Ownership interest Management position; Cerescan Imaging Consulting; Headwatersmb Consulting fee Consulting; Venturequest Royalty Consulting

References

  1. Kiroglu AF, Cankaya H, Yuca K, Kiris M. Endoscopic dacryocystorhinostomy with a T-type ventilation tube. J Otolaryngol. Jun 2007;36(3):164-7. [Medline].

  2. Sprekelsen MB, Barberan MT. Endoscopic dacryocystorhinostomy: surgical technique and results. Laryngoscope. Feb 1996;106(2 Pt 1):187-9. [Medline].

  3. Anari S, Ainsworth G, Robson AK. Cost-efficiency of endoscopic and external dacryocystorhinostomy. J Laryngol Otol. Jul 19 2007;1-4. [Medline].

  4. Pearlman SJ, Michalos P, Leib ML, Moazed KT. Translacrimal transnasal laser-assisted dacryocystorhinostomy. Laryngoscope. Oct 1997;107(10):1362-5. [Medline].

  5. Bumsted RM, Linberg JV, Anderson RL, Barreras R. External dacryocystorhinostomy. A prospective study comparing the size of the operative and healed ostium. Arch Otolaryngol. Jul 1982;108(7):407-10. [Medline].

  6. Fernandes SV. Postoperative care in functional endoscopic sinus surgery?. Laryngoscope. Jun 1999;109(6):945-8. [Medline].

  7. Hausler R, Caversaccio M. Microsurgical endonasal dacryocystorhinostomy with long-term insertion of bicanalicular silicone tubes. Arch Otolaryngol Head Neck Surg. Feb 1998;124(2):188-91. [Medline].

  8. McDonogh M, Meiring JH. Endoscopic transnasal dacryocystorhinostomy. J Laryngol Otol. Jun 1989;103(6):585-7. [Medline].

  9. Metson R. The endoscopic approach for revision dacryocystorhinostomy. Laryngoscope. Dec 1990;100(12):1344-7. [Medline].

  10. Selig YK, Biesman BS, Rebeiz EE. Topical application of mitomycin-C in endoscopic dacryocystorhinostomy. Am J Rhinol. May-Jun 2000;14(3):205-7. [Medline].

  11. Leong SC, Macewen CJ, White PS. A systematic review of outcomes after dacryocystorhinostomy in adults. Am J Rhinol Allergy. Jan-Feb 2010;24(1):81-90. [Medline].

  12. Orhan M, Saylam CY, Midilli R. Intranasal localization of the lacrimal sac. Arch Otolaryngol Head Neck Surg. Aug 2009;135(8):764-70. [Medline].

 
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Schematic endoscopic view of the area of lacrimal sac.
Schematic coronal section through the lacrimal drainage system.
Schematic axial section at the level of the lacrimal sac.
 
 
 
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