BACKGROUND: This prospective clinical study evaluates the effect of a silicone stent tube (SST) on the success rate of endonasal-endoscopic dacryocystorhinostomy (EN-DCR) to treat primary acquired nasolacrimal duct obstruction.
METHODS: Patients were randomly assigned to receive EN-DCR with or without SST intubation over a period of 3 months. The surgery was performed using standardized techniques. Patients were assessed at three different timepoints: one day, 12 weeks and 24 weeks after the surgery. The results were compared in order to evaluate statistical differences. Surgical success was determined by means of positive irrigation procedures, as well as by the improvement of symptoms and a high level of patient satisfaction.
RESULTS: A total of 56 randomized cases completed 24 weeks of follow up. 1 Patient dropped out due to malignant genesis of the nasolacrimal duct obstruction. After 24 weeks of follow up no statistically significant differences in levels of epiphora (p > .10) or patency (p > .16) were revealed. Comparisons regarding changes in time did not show levels of significance (p > .28).
CONCLUSIONS: This study could not confirm a statistically significant benefit or disadvantage for SST Insertion in EN-DCR.

OBJECTIVE: Exploring the prevalence of dry eye (DE) and the changes of tear film stability in patients with primary acquired obstruction of the nasolacrimal duct (PANDO).
METHODS: In this cross-sectional, observational study, 370 eyes in 223 patients with PANDO were assessed. The ocular surface disease index (OSDI) was used to evaluate ocular surface symptoms, and the Keratograph 5M non-invasive ocular surface analyser was used to assess ocular surface parameters. According to the TFOS DEWS II criteria, patients with OSDI ≥ 13 and NIKBUT < 10 s were diagnosed with DE.
RESULTS: Of the 223 PANDO patients, 65 (29.1%) met the diagnostic criteria for DE. Compared with patients without DE, PANDO patients with DE were significantly older (p < 0.001), had a longer duration of epiphora (p = 0.023), and more likely to have a positive regurgitation on pressure over the lacrimal sac (ROPLAS) sign (p = 0.003). Multifactorial analysis showed that older age, positive ROPLAS and hypertension were significant independent predictors of DE (p < 0.05). Among the 147 unilateral PANDO patients without DE, the TMH, NIKBUT-first, NIKBUT-average and bulbar erythema scores were significantly higher in the PANDO sides.
CONCLUSIONS: This study illustrated the prevalence of DE in PANDO patients was 29.1% and DE is more likely to occur in those who are older, have hypertension and are positive for ROPLAS. In addition, in patients with unilateral nasolacrimal duct obstruction, a decrease in tear film stability was observed in the healthy eye.

OBJECTIVE: The most prevalent lacrimal apparatus dysfunctions associated with differentiated thyroid cancer(DTC) after I-131 therapy are dry eye and nasolacrimal duct obstruction(NLDO), leading to ocular discomfort and lower quality of life for patients. It is crucial to diagnose and manage lacrimal apparatus dysfunction associated with I-131 therapy for DTC. Therefore, this review aims to comprehensively summarize and analyze the advances in mechanisms and therapeutic options underlying lacrimal apparatus dysfunction induced by I-131 therapy for DTC.
METHODS: A comprehensive search of CNKI, PubMed, and Wed of Science was performed from the database to December of 2023. Key search terms were \"Thyroid cancer\", \"I-131\", \"Complications\", \"Dry eye\", \"Epiphora\", \"Tear\", \"Nasolacrimal duct\" and \"NLDO\".
RESULTS: The research indicates that I-131 therapy for DTC causes damage to the lacrimal glands and nasolacrimal duct system, resulting in symptoms such as dry eye, epiphora, and mucoid secretions. Moreover, recent research has focused on exploring relevant risk factors of the condition and experimental and clinical treatments. However, there is some controversy regarding the mechanisms involved, whether it is due to the passive flow of I-131 in tears, active uptake of I-131 by the sodium-iodide symporter (NIS) in the lacrimal sac and nasolacrimal duct, or secondary metabolic and hormonal disturbances caused by I-131.
CONCLUSIONS: It is crucial for early detection and preventive measures by ophthalmologists and the need for further studies to elucidate the mechanisms underlying the disease.

暂无摘要。

OBJECTIVE: To study the outcomes of balloon dacryoplasty (BD) or (BDCP) in children with persistent congenital nasolacrimal duct obstruction (pCNLDO) by using new and reused balloon catheters.
METHODS: Our retrospective analysis focused on managing pCNLDO by using the BD or BDCP technique. The study included children aged >1 year to <12 years who underwent single or multiple probings before. Our specific lacrimal workup included a detailed history and examination, as published earlier. We used conventional, straight, 2 mm × 13 mm/3 mm × 15 mm lacrimal balloons (FCI, Ophthacath). We have described a technique to use the same catheter for three BD procedures (1 new + 2 reuse). The outcomes were categorized as complete success, partial success, and failure. The minimum follow-up of each child was 6 months.
RESULTS: We analyzed 64 children (89 eyes) with a mean age of 58 months (15-132 months). All children (100%) had epiphora with discharge and positive FDDT. All children underwent BD under general anesthesia - new balloons in 59 eyes and reused balloons in 30 eyes. The balloons were plasma sterilized akin to vitrectomy cutters and tubings of phaco machines. We noted three leaks from reused balloons (2 from the balloon tip and 1 from the plastic hub). At a mean follow-up of 14.5 months, complete success was noted in 77 eyes (86.5%) (52 new and 25 reuse), while 8 eyes had partial success (8.9%) (4 new and 4 reuse). Failure of BD was noted in four eyes (4.5%) (3 new and 1 reuse). None had significant complications with new or reused balloons.
CONCLUSIONS: BD or BDCP is a quick, safe, easy, and effective procedure that resolves pCNLDO symptoms satisfactorily. Carefully reusing a conventional balloon catheter is possible with comparable efficacy and no additional complications in pCNLDO.

BACKGROUND: Utilizing expanded endoscopic approaches to the maxillary sinus for the endonasal management of a variety of tumors is increasing in popularity. The nasolacrimal duct (NLD) may be injured inadvertantly or need to be removed during tumor resection or to augment visualization. Management of the NLD can take the form of transection alone, transection with stenting, or performing a formal dacryocystorhinostomy to avoid postoperative sequelae of injury. The purpose of this study was to review the literature and determine the optimal management of the NLD during expanded maxillary sinus approaches.
METHODS: A systematic review of Ovid, Embase, Medline, and Cochrane databases was performed to identify studies involving expanded approaches to the maxillary sinus and that explicitly reported the status of the NLD and postoperative outcomes.
RESULTS: Nineteen studies were included in the analysis and divided into two groups: NLD-preserving (n = 9 studies; n = 191 patients in aggregate) and NLD-involving (n = 10 studies; n = 296 patients in aggregate). In the NLD-preserving subgroup, one patient out of a subgroup aggregate of 191 patients (0.5%) developed epiphora. In the NLD-involving subgroup, sharp transection alone was the most common method of NLD removal and was associated with a low rate of epiphora (study rates: 0 to 18.2%; aggregated subgroup rate: 7.0%, 21 / 296). Spontaneous resolution of symptoms was common (60%-100% cases).
CONCLUSIONS: The NLD should be preserved when feasible from an exposure and tumor-control perspective. When pathology or approach requires the removal of the NLD, rates of persistent epiphora are very low, regardless of surgical technique. When expanded maxillary approaches are employed, particularly for benign tumors, and require removal of the NLD, sharp transection is the simplest method of removal, provides a low rate of postoperative epiphora, and is supported by the available literature.

OBJECTIVE: To describe the use of an endoscope to assist in performing minimally invasive dacryocystorhinostomy in a dog to successfully manage a nasolacrimal duct cyst (dacryocyst).
METHODS: A 4-year-old female spayed American Staffordshire Terrier with chronic epiphora and swelling ventromedial to the nasal canthus of the right eye and reverse sneezing.
METHODS: Computed tomography revealed a fluid-filled cystic lesion of the right nasolacrimal duct with extensive nasal extension and secondary obstructive frontal sinusitis. Aspiration of serosanguinous fluid with no growth of microbial organisms and histopathology confirmed the cystic nature of the structure. A 2.7 mm, 30 deg, 11 cm foreward-oblique endoscope with arthroscopic cannula was passed through a mucosal stab incision in the dorsal buccal recess into the cyst to allow for exploration. A separate instrument portal was placed in the center of the cyst through the skin which allowed for transcutaneous dacryocystorhinostomy with a meniscal probe to be performed. No clear communication was evident caudodorsally into the frontal sinus on endoscope examination. A small frontal sinus trephination was performed and lavage flowed easily into the cystic cavity and out of the nostril.
RESULTS: Follow-up at 10 days and 17 months postoperatively showed complete resolution of clinical signs with an excellent cosmetic outcome.
CONCLUSIONS: Endoscopy-assisted dacryocystorhinostomy demonstrated an effective minimally invasive technique to treat a functionally obstructive dacryocyst of the right nasolacrimal duct in a dog.

The article analyzes the literature data concerning the anatomical structure of the tear ducts with a focus on morphometric studies of individual structures. It is noted that, despite the high information content of cadaveric studies, most of the information to date has been obtained with the use of intravital radiation visualization methods. It is shown that the lacrimal drainage system has age, gender, and racial characteristics. Most studies focus on features of the bone nasolacrimal canal, while there is a relative shortage of research devoted to soft-tissue nasolacrimal duct. The analysis showed that most of the studies are devoted to particular morphometric indicators, which makes it difficult to obtain a complete objective picture of the size of the tear duct. Information about its volume can be found only in a couple of studies. The numerical values of the obtained data vary, which can be explained by a different approach to the selection of research subjects, sample sizes, anatomical criteria and the calculation method of morphometric parameters. There are only a few studies on morphometric parameters of the nasolacrimal duct in healthy humans, which is extremely important for determining the pathogenesis of disorders of the patency of the lacrimal drainage system.
Проанализированы данные литературы, касающиеся анатомического строения слезоотводящих путей с фокусировкой на морфометрические исследования отдельных структур. Отмечено, что, несмотря на высокую информативность кадаверных исследований, большинство сведений к настоящему времени получено в результате прижизненного применения лучевых визуализирующих методов. Показано, что слезоотводящие пути имеют возрастные, гендерные и расовые особенности. Большинство исследований сосредоточено на изучении особенностей костного носослезного канала, в то время как имеется относительный дефицит работ, посвященных изучению мягкотканного носослезного протока. Анализ показал, что в публикациях приведены преимущественно отдельные морфометрические показатели, и это затрудняет получение целостной объективной картины размеров носослезного канала. Сведения о его объеме представлены в единичных работах. Цифровые значения полученных данных разнятся, что можно объяснить различными подходами к отбору субъектов исследования, размеров выборки, анатомических критериев и методов вычисления морфометрических показателей. Практически отсутствуют работы по изучению морфометрических показателей носослезного протока в норме, информация о которых крайне важна для определения патогенеза нарушений проходимости слезоотводящих путей.

Among secondary forms of nasolacrimal duct obstruction caused by radioactive iodine therapy, its distal forms localized in the area of the Hasner\'s valve are predominant. In this regard, during dacryocystorhinostomy (DCR) there is a high probability of developing the sump syndrome, for which the anatomical prerequisite is that the lower edge of the DCR ostium is above the level of obstruction. In such cases, we propose to supplement DCR with a counteropening in the area of the Hasner\'s valve.
OBJECTIVE: This study analyzes the clinical effectiveness of dacryocystorinostomy with a counteropening.
METHODS: The outcomes of 49 surgeries (49 patients) with secondary acquired nasolacrimal duct obstruction due to radioactive iodine therapy were analyzed, including 34 DCR and 15 DCR with a counteropening. The clinical outcomes were analyzed over the longest possible period after surgery. The analysis included the severity of tearing on the Munk scale, the characteristic of the formed ostium on the M. Ali scale and the height of the tear meniscus. Differences were considered significant at a confidence level of 95% (p≤0.05).
RESULTS: Analysis of the results of the performed surgeries showed that DCR was clinically effective in 30 (88%) cases, DCR with a counteropening - in 15 (100%) cases. The differences were not statistically significant in the total sample, but were statistically significant when comparing the results of surgeries in patients with distal obliteration.
CONCLUSIONS: The developed and clinically tested method of DCR with a counteropening in the area of the Hasner\'s valve was completely effective in 15 patients with secondary nasolacrimal duct obstruction caused by radioiodine therapy.
В структуре вторичных облитераций слезоотводящих путей вследствие терапии радиоактивным йодом преобладают дистальные формы, локализующиеся в области устья носослезного протока. В связи с этим при проведении дакриоцисториностомии (ДЦР) велика вероятность развития sump-синдрома, анатомической предпосылкой которого является формирование нижнего края дакриостомы выше уровня облитерации. В таких случаях авторы предлагают дополнять ДЦР наложением контрапертуры в области устья носослезного протока.
UNASSIGNED: Анализ клинической эффективности операции ДЦР с наложением контрапертуры.
UNASSIGNED: Проанализированы исходы 49 операций (49 пациентов) со вторичной облитерацией слезоотводящих путей вследствие терапии радиоактивным йодом, включая 34 ДЦР и 15 ДЦР с наложением контрапертуры. При анализе клинических исходов оценивали результаты на максимально отдаленном сроке после операции. Определяли выраженность слезотечения по шкале Munk, характеристику сформированной дакриостомы по шкале M. Ali и высоту слезного мениска. Различия считали достоверными при уровне достоверности 95% (p≤0,05).
UNASSIGNED: Анализ результатов проведенных операций показал, что ДЦР была клинически эффективна в 30 (88%) случаях, ДЦР с контрапертурой — в 15 (100%) случаях. Различия не были статистически достоверны в общей выборке, однако были статистически достоверны при сравнении результатов операций у пациентов с дистальной облитерацией.
UNASSIGNED: Разработанная и апробированная в клинике операция ДЦР с наложением контрапертуры в области устья носослезного протока показала абсолютную эффективность у 15 пациентов с вторичной облитерацией слезоотводящих путей вследствие терапии радиоактивным йодом.

A 47-year-old Japanese woman presented with a 1-year history of right-sided epiphora. On initial consultation, the patient had a high right tear meniscus height. CT images revealed bilateral soft tissue opacification in the nasal cavity and maxillary, frontal, and ethmoid sinuses. The lesion in the right nasal cavity and maxillary sinus involved the right lacrimal sac and nasolacrimal duct. Blood test results showed elevated eosinophil count. Endoscopic sinus surgery and excisional biopsy of the nasolacrimal duct were performed. Histopathological examinations of the excised right nasolacrimal duct and nasal polyps from the nasal cavity and maxillary sinus showed high levels of eosinophilic inflammatory infiltrates. The definite diagnosis of eosinophilic chronic rhinosinusitis was made, based on clinical, radiological, and histopathological findings. At 1.5-year follow-up, tear meniscus height was normal, the lacrimal drainage system remained patent, and the rhinosinusitis did not recur.