Definition
Trauma of the lacrimal sac and nasolacrimal duct.
Etiology
Etiology of lacrimal sac and nasolacrimal duct trauma is typically mechanical – be it penetrating laceration, avulsion, or blunt injury. High impact blunt trauma causing naso-orbital-ethmoid (NOE), Le Fort II, and Le Fort III type fractures are often associated with osseous or soft tissue injuries to the lacrimal sac and nasolacrimal duct. In 7–15% of all facial traumas, bony fractures of the nasolacrimal duct are discovered. Injury to the nasolacrimal system may be structural at the time of initial trauma or may develop from fibrosis and subsequent dacryostenosis. Iatrogenic causes of trauma to the lacrimal sac and nasolacrimal duct include probing, lacrimal intubation, and sinus surgery.
Clinical Presentation
Lacerations to the medial portion of the eyelid can be associated with soft tissue injury to the lacrimal sac. Patients may not develop tearing immediately and dacryocystitis or nasolacrimal duct obstruction...
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Further Reading
Ali MJ (2014) In: Javed Ali M (ed) Principles and practice of lacrimal surgery. Springer, New Delhi
Ali MJ, Gupta H, Honavar SG, Naik MN (2012) Acquired nasolacrimal duct obstructions secondary to naso-orbito-ethmoidal fractures: patterns and outcomes. Ophthal Plast Reconstr Surg 28:242–245
Becelli R, Renzi G, Mannino G, Cerulli G, Iannetti G (2004) Posttraumatic obstruction of lacrimal pathways: a retrospective analysis of 58 consecutive naso-orbitoethmoid fractures. J Craniofac Surg 15:29–33
Cohen AJ, Mercandetti M, Brazzo B (2014) In: Cohen AJ, Mercandetti M, Brazzo B (eds) The lacrimal system. Springer, Cham
Gruss JS, Hurwitz JJ, Nik NA, Kassel EE (1985) The pattern and incidence of nasolacrimal injury in naso-orbital-ethmoid fractures: the role of delayed assessment and dacryocystorhinostomy. Br J Plast Surg 38:116–121
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Segal, K.L., Tsiouris, A.J., Lelli, G.J. (2018). Trauma, Lacrimal Sac and Nasolacrimal Duct. In: Schmidt-Erfurth, U., Kohnen, T. (eds) Encyclopedia of Ophthalmology. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-69000-9_1345
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DOI: https://doi.org/10.1007/978-3-540-69000-9_1345
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