J Korean Ophthalmol Soc.  2017 Jun;58(6):634-639. 10.3341/jkos.2017.58.6.634.

Evaluation of Bony Nasolacrimal Ducts in Koreans with Primary Acquired Nasolacrimal Duct Obstruction

• Kim SY
• Son BJ

• KMID: 2382670
• DOI: http://doi.org/10.3341/jkos.2017.58.6.634

Abstract

PURPOSE
To evaluate the morphometric differences of bony nasolacrimal ducts (BNLDs) using computed tomography (CT) in Koreans with primary acquired nasolacrimal duct obstruction (PANDO).
METHODS
From March 2014 to March 2016, 40 unilateral PANDO patients and 40 control subjects were retrospectively reviewed. The axial, sagittal, and coronal planes of CT were used for image evaluation. The proximal, minimal, and distal transverse diameters (TDs) of the BNLD were assessed. The length, sagittal orientation angle of BNLD, relative lacrimal sac-BNLD angle, nasal floor-BNLD angle, and turbinate angle were investigated. In addition, the distance between the bilateral BNLD and inter-frontozygomatic suture distance were also measured.
RESULTS
There were no morphologic differences between the PANDO and non-PANDO sides within PANDO patients. The proximal and minimum BNLD TD measurements were significantly narrower in the PANDO patients, as compared with the control group (p = 0.010 and p = 0.017, respectively). The lacrimal sac-BNLD angle, nasal floor-BNLD angle, and turbinate angle also exhibited statistically significant differences between the PANDO patients and the control group (p = 0.019, p = 0.001, and p < 0.001, respectively).
CONCLUSIONS
Although this study was performed in a small group, the narrow proximal and minimum BNLD TD in PANDO patients (in both the PANDO and non-PANDO sides) may be associated with PANDO development in Koreans. Additionally, the narrow lacrimal sac-BNLD, nasal floor-BNLD, and turbinate angle might be possible causative factors of PANDO.

Keyword

Bony nasolacrimal duct; Computed tomography; Nasolacrimal duct obstruction

MeSH Terms

Humans
Nasolacrimal Duct*
Retrospective Studies
Sutures
Turbinates

Figure

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  Figure 1 Bony nasolacrimal duct (BNLD) measurements with computed tomography (CT). (A) Axial CT image in bone window demonstrates BNLD transverse diameter (yellow line) measurement. (B) It reveals distance between the proximal BNLD (green line). (C) It shows inter-frontozygomatic suture distance (white line).

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  Figure 2 Bony nasolacrimal duct (BNLD) measurements with computed tomography (CT). (A) Sagittal CT image reveals BNLD length (orange line) and proximal, minimal, distal BNLD anteroposterior diameter (yellow lines) measurements, respectively. ‘a’ demonstrates measurement of sagittal orientation angle between long axis (white line) of BNLD and nasal floor (black line). (B) Coronal CT image shows relative lacrimal sac-BNLD orientation angle ‘b’ between long axis of lacrimal sac fossa (green line) and BNLD (white line). ‘c’ reveals angle between long axis of BNLD (white line) and nasal floor (black line). (C) It demonstrates angle (red line) between the bony inferior turbinate and upper part of the medial wall of the maxillary sinus.

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