International Ophthalmology

, Volume 38, Issue 6, pp 2463–2469 | Cite as

Morphology and morphometry of lacrimal drainage system in relation to bony landmarks in Caucasian adults: a cadaveric study

  • Mohammad Javed Ali
  • Martin Schicht
  • Friedrich Paulsen
Original Paper



The objective of this study is to examine the morphometry of the lacrimal drainage system with reference to bony landmarks in the vicinity.


Twenty midsaggitalized heads obtained from sixteen preserved cadavers were studied. Measurements involved detailed morphometry of anterior and posterior lacrimal crests, bony lacrimal sac fossa, entrance and length of the bony nasolacrimal duct (NLD), attachment of Horner’s muscle, and characteristics of the inferior meatal opening of the NLD.


The mean lengths of anterior and posterior lacrimal crests were 16.3 and 12.5 mm, respectively. At the midpoint of the posterior lacrimal crest, Horner’s muscle was found to be attached at a mean of 1.3 mm posterior to the crest. The mean dimensions of the bony lacrimal sac fossa at superior, mid and inferior levels were 6.5, 8.7, and 5.9 mm, respectively. The mean contribution of the lacrimal bone to the lacrimal sac fossa was 56.2%. The mean anteroposterior and transverse diameters of the entrance of the bony NLD were 5.7 and 4.7 mm, respectively. The most common type of NLD opening in the inferior meatus was that of “vertical sulcus” (70%, 14/20). The mean distance of the NLD opening from the anterior nasal spine and Limen nasi were 22.2 and 18.9 mm, respectively.


This study provides useful anatomical and positional relationship of bony lacrimal landmarks and nasolacrimal duct in Caucasian adults.


Anatomy Lacrimal Nose Cadaver Nasolacrimal duct 



The authors wish to acknowledge the technical help of Ms. Hong Nguyen during cadaveric dissections as well as the help of Mr. Thorsten Hummel for cadaver prearrangement. Mohammad Javed Ali received support from the Alexander von Humboldt Foundation for his research, and he also receives royalties from Springer for the textbook “Principles and Practice of Lacrimal Surgery.” Friedrich Paulsen was supported by Deutsche Forschungsgemeinschaft (DFG) Grants PA738/1-1 to 1-5 as well as PA738/2-1. He receives royalties from Elsevier for the anatomy atlas “Sobotta.”

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


  1. 1.
    Takahashi Y, Nakata K, Miyazaki H et al (2014) Comparison of bony nasolacrimal canal narrowing with or without primary acquired nasolacrimal duct obstruction in a Japanese population. Ophthal Plast Reconstr Surg 30:434–438CrossRefGoogle Scholar
  2. 2.
    Kakizaki H, Ichinose A, Takahashi Y et al (2012) Anatomical relationship of Horner’s muscle origin and posterior lacrimal crest. Ophthal Plast Reconstr Surg 28:66–68CrossRefGoogle Scholar
  3. 3.
    Kakizaki H, Zako M, Nakano T et al (2004) The medial horn and capsulopalpebral fascia in the medial canthus are significant antagonist of the orbicularis oculi muscle for lacrimal drainage. Ophthalmologica 218:419–423CrossRefGoogle Scholar
  4. 4.
    Takahashi Y, Nakamura Y, Nakano T et al (2013) The narrowest part of the bony nasolacrimal canal: an anatomical study. Ophthal Plast Reconstr Surg 29:318–322CrossRefGoogle Scholar
  5. 5.
    Park J, Takahashi Y, Nakano T et al (2012) The orientation of the lacrimal sac fossa to the bony nasolacrimal canal: an anatomical study. Ophthal Plast Reconstr Surg 28:463–466CrossRefGoogle Scholar
  6. 6.
    Kim YH, Park MG, Kim GC et al (2012) Topography of the nasolacrimal duct on the lateral nasal wall in Koreans. Surg Radiol Anat 34:249–255CrossRefGoogle Scholar
  7. 7.
    Takahashi Y, Kakizaki H, Nakano T (2011) Bony nasolacrimal duct entrance diameter: gender difference in cadaveric study. Ophthal Plast Reconstr Surg 27:204–205PubMedGoogle Scholar
  8. 8.
    Ipek E, Ezin K, Amac K et al (2007) Morphological and morphometric evaluation of lacrimal groove. Anat Sci Int 82:207–210CrossRefGoogle Scholar
  9. 9.
    Ali MJ, Nayak JV, Vaezeafshar R et al (2014) Anatomical relationship of nasolacrimal duct and major lateral wall landmarks: cadaveric study with surgical implications. Int Forum Allergy Rhinol 4:684–688CrossRefGoogle Scholar
  10. 10.
    Orhan M, Ikiz ZAA, Saylam CY (2009) Anatomical features of the opening of nasolacrimal duct and the lacrimal fold for intranasal surgery. Clin Anat 22:925–931CrossRefGoogle Scholar
  11. 11.
    Shams PN, Abed SF, Shen S et al (2012) A cadaveric study of the morphometric relationships and bony composition of the Caucasian nasolacrimal sac fossa. Orbit 31:159–161CrossRefGoogle Scholar
  12. 12.
    Elshaarawy EA (2014) Morphological and morphometrical study of the nasal opening of nasolacrimal duct in man. Folia Morphol 73:321–330CrossRefGoogle Scholar
  13. 13.
    Putz R (1971) Anatomy of the orifice of nasolacrimal duct. Verh Anat Ges 65:377–381PubMedGoogle Scholar

Copyright information

© Springer Science+Business Media B.V. 2017

Authors and Affiliations

  • Mohammad Javed Ali
    • 1
    • 2
  • Martin Schicht
    • 2
  • Friedrich Paulsen
    • 2
  1. 1.Govindram Seksaria Institute of DacryologyL.V.Prasad Eye InstituteHyderabadIndia
  2. 2.Institute of AnatomyFriedrich-Alexander-University Erlangen-NürnbergErlangenGermany

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