J Korean Ophthalmol Soc.  2013 May;54(5):794-797. 10.3341/jkos.2013.54.5.794.

A Case of Nasolacrimal Duct Obstruction after Two-Jaw Surgery

• Kang WS
• Ahn M

• KMID: 2217048
• DOI: http://doi.org/10.3341/jkos.2013.54.5.794

Abstract

PURPOSE
To describe a case of nasolacrimal duct obstruction after two-jaw surgery.
CASE SUMMARY
A 22-year-old woman presented with a 1-year history of epiphora after two-jaw surgery. Orbital CT showed 5 mm of focal soft tissue at the level of the distal nasolacrimal duct. Dacryocystography showed complete obstruction at the nasolacrimal duct level. Thus a nasolacrimal duct obstruction was diagnosed by physical and radiologic examination.
CONCLUSIONS
In patients with epiphora who have undergone two-jaw surgery, precise examination and treatment is required in order to exclude nasolacrimal duct obstruction.

Keyword

Epiphora; Nasolacrimal duct obstruction; Two-jaw surgery

MeSH Terms

Female
Humans
Lacrimal Apparatus Diseases
Nasolacrimal Duct
Orbit

Figure

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  Figure 3. A Dacryocystography of the patient shows complete obstruction of the right nasolacrimal duct.

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  Figure 4. The osteotomy line of conventional Lefort surgery is shown by the dotted line. The inferior orifice of the nasolacri-mal canal (black arrow) is located at the top of the curved in-sertion of the inferior turbinate.

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  Figure 1. A general sequence of two-jaw surgery. After osteotomy of the maxilla and mandibule, trimming of the bone for adjustments should be done (B). Repo- sitioning of the bones (C). Bone plates and screws used for fixation of the bones (D).

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  Figure 2. A continuous coro-nal section of facial CT (A-D) shows nasolacrimal duct (long arrow) and fracture line of Lefort surgery (small arrow). A right nasolacrimal duct opening is obstructed with soft tissue (D).

Reference

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