Reza SAMAREI
(Urmia University of Medical Sciences, Department of Otolaryngology, Urmia, Iran)
Vafa SAMAREI
(Urmia University of Medical Sciences, Department of Ophthalmology, Urmia, Iran)
Naser Samadi AIDENLOO
(Urmia University of Medical Sciences, Department of Ophthalmology, Urmia, Iran)
Nasrin FATEH
(Urmia University of Medical Sciences, Department of Otolaryngology, Urmia, Iran)
Yıl: 2020Cilt: 52Sayı: 1ISSN: 1308-8734 / 1308-8742Sayfa Aralığı: 21 - 24İngilizce

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Sinonasal Anatomical Variations and Primary Acquired Nasolacrimal Duct Obstruction: A Single Centre, Case-Control Investigation
Objective: Primary acquired nasolacrimal duct obstruction (PANDO) is an idiopathic narrowing of the nasolacrimal duct caused by chronic inflammation and consecutive stenosis of the nasal tissue. In the current investigation, we aimed to study the etiopathogenic role of sinonasal anatomical abnormalities and paranasal inflammatory pathologies in PANDO. Materials and Methods: Computed tomography (CT) findings of 459 patients who were diagnosed with unilateral PANDO between April 2009 and March 2017 were compared with that of a control group, which comprised 200 subjects without nasolacrimal duct obstruction who had been referred to the ear nose throat (ENT) clinic with the complaint of vertigo and headache. A radiologist (R. S.) masked to the clinical situation of participants retrospectively examined their CT findings. Results: The prevalence of deviated nasal septum was found to be strongly associated with PANDO incidence (55.3% on PANDO side of patients vs. 28.3% among controls; p˂0.001). Significant increases, albeit of smaller magnitude, were also observed in the relative frequency of Agger nasi cells and maxillary sinusitis on the PANDO side of the subjects (14.6% and 27.0%, respectively) compared to controls (9.5% and 20.6%, respectively) (p=0.023 and p=0.038, respectively). Unilateral PANDO was also found to be robustly associated with an ipsilateral deviated nasal septum (p˂0.001). The odds of septal deviation occurrence were 3.037 times (95% Confidence Interval (CI): 2.303-3.990; p˂0.001) more on the PANDO than the non-PANDO side of the studied cases. Conclusion: Ipsilaterally deviated nasal septum appears to have a role in the development of unilateral primary acquired obstructive disease of the lacrimal drainage system. The incidence of PANDO might also be affected by Agger nasi cells and maxillary sinusitis. Multicenter studies are essential to further elucidate the interaction between type, severity, extent, and dimensions of different pathologies with nasolacrimal duct obstruction.
DergiAraştırma MakalesiErişime Açık
  • 1. Paulsen FP, Thale AB, Maune S, Tillmann BN. New insights into the pathophysiology of primary acquired dacryostenosis. Ophthalmology 2001; 108: 2329-36. [CrossRef]
  • 2. Kashkouli MB, Sadeghipour A, Kaghazkanani R, Bayat A, Pakdel F, Aghai GH. Pathogenesis of primary acquired nasolacrimal duct obstruction. Orbit 2010; 29: 11-5. [CrossRef]
  • 3. Linberg JV, McCormick SA. Primary acquired nasolacrimal duct obstruction. A clinicopathologic report and biopsy technique. Ophthalmology 1986; 93: 1055-63. [CrossRef]
  • 4. Ohtomo K, Ueta T, Toyama T, Nagahara M. Predisposing factors for primary acquired nasolacrimal duct obstruction. Graefes Arch Clin Exp Ophthalmol 2013; 251: 1835-9. [CrossRef]
  • 5. Seider N, Miller B, Beiran I. Topicalglaucomatherapy as a risk factor for nasolacrimal duct obstruction. Am J Ophthalmol 2008; 145: 120-3. [CrossRef]
  • 6. Habesoglu M, Eriman M, Habesoglu TE, et al. Cooccurrence and possible role of sinonasal anomalies in primary acquired nasolacrimal duct obstruction. J Craniofac Surg 2013; 24: 497-500. [CrossRef]
  • 7. Kim YH, Park MG, Kim GC, Park BS, Kwak HH. Topography of the nasolacrimal duct on the lateral nasal wall in Koreans. Surg Radiol Anat 2012; 34: 249-55. [CrossRef]
  • 8. Borges Dinis P, Oliveira Matos T, Angelo P. Does sinusitis play a pathogenic role in primary acquired obstructive disease of the lachrymal system? Otolaryngol Head Neck Surg 2013; 148: 685-8. [CrossRef]
  • 9. Bulbul E, Yazici A, Yanik B, Yazici H, Demirpolat G. Morphometric Evaluation of BonyNasolacrimal Canal in a Caucasian Population with Primary Acquired Nasolacrimal Duct Obstruction: A Multidetector Computed Tomography Study. Korean J Radiol 2016; 17: 271-6. [CrossRef]
  • 10. Estes JL, Tsiouris AJ, Christos PJ, Lelli GJ. Three-dimensional volumetric assessment of the nasolacrimal duct in patients with obstruction. Ophthalmic Plast Reconstr Surg 2015; 31: 211-4. [CrossRef]
  • 11. Kallman JE, Foster JA, Wulc AE, Yousem DM, Kennedy DW. Computed tomography in lacrimal outflow obstruction. Ophthalmology 1997; 104: 676-82. [CrossRef]
  • 12. Sefİ N, Uğurlu Ş, Erdoğan N, Türe M, Maden A. Nasal and paranasal sinus diseases in the development of primary acquired nasolacrimal duct obstruction. Turkiye Klinikleri Journal of Ophthalmology 2001; 10: 8.
  • 13. Singh S, Alam MS, Ali MJ, Naik MN. Endoscopic intranasal findings in unilateral primary acquired nasolacrimal duct obstruction. Saudi J Ophthalmol 2017; 31: 128-30. [CrossRef]
  • 14. Takahashi Y, Nakata K, Miyazaki H, Ichinose A, Kakizaki H. Comparison of bony nasolacrimal canal narrowing with or without primary acquired nasolacrimal duct obstruction in a Japanese population. Ophthalmic Plast Reconstr Surg 2014; 30: 434-8. [CrossRef]
  • 15. Yazici H, Bulbul E, Yazici A, et al. Primary acquired nasolacrimal duct obstruction: is it really related to paranasal abnormalities? Surg Radiol Anat 2015; 37: 579-84. [CrossRef]
  • 16. Eyigor H, Unsal AI, Unsal A. The role of accompanying sinonasal abnormalities in the outcome of endonasal dacryocystorhinostomy. Am J Rhinol 2006; 20: 620-4. [CrossRef]
  • 17. Choi SC, Lee S, Choi HS, Jang JW, Kim SJ, Lee JH. Preoperative Computed Tomography Findings for Patients with Nasolacrimal Duct Obstruction or Stenosis. Korean J Ophthalmol 2016; 30: 243- 50. [CrossRef]
  • 18. Ivaniševic M, Bojic L, Lešin M, Žuljan I, Bucan K, Kovacic Ž. Primary acquired nasolacrimal ducto bstruction: epidemiological analysis of 91 patients. Med Jad 2007; 37: 37-41.
  • 19. Shweel M, Elshafei A, AbdelRahman RME-D, Nassar M. Evaluation of lacrimal drainage system obstruction using combined multidetector CT and instillation dacryocystography. Egypt J Radiol Nucl Med 2012; 43: 413-20. [CrossRef]
  • 20. Lee JS, Lee H, Kim JW, Chang M, Park M, Baek S. Association of facial asymmetry and nasal septal deviation in acquired nasolacrimal duct obstruction in East Asians. J Craniofac Surg 2013; 24: 1544-8. [CrossRef]
  • 21. Taban M, Jarullazada I, Mancini R, Hwang C, Goldberg RA. Facial asymmetry and nasal septal deviation in acquired nasolacrimal duct obstruction. Orbit 2011; 30: 226-9. [CrossRef]
  • 22. Aramani A, Karadi R, Kumar S. A study of anatomical variations of osteomeatalcomplex in chronic rhinosinusitis patients-CT findings. J Clin Diagn Res 2014; 8: KC01. [CrossRef]
  • 23. Sivasli E, Sirikci A, Bayazyt YA, et al. Anatomic variations of the paranasal sinus area in pediatric patients with chronic sinusitis. Surg Radiol Anat 2003; 24: 400-5. [CrossRef]
  • 24. Wani AA, Kanotra S, Lateef M, Ahmad R, Qazi SM, Ahmad S. CT scan evaluation of the anatomical variations of the ostiomeatal complex. Indian J Otolaryngol Head Neck Surg 2009; 61: 163-8. [CrossRef]
  • 25. Bolger WE, Butzin CA, Parsons DS. Paranasal sinus bony anatomic variations and mucosal abnormalities: CT analysis for endoscopic sinus surgery. Laryngoscope 1991; 101: 56-64. [CrossRef]
  • 26. Stammberger HR, Kennedy DW. Paranasal sinuses: anatomic terminology and nomenclature. Ann Otol Rhinol Laryngol 1995; 104: 7-16. [CrossRef]

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